|
APREPITANT 40 MG CAPSULE
|
Facility
|
IP
|
$1,545.68
|
|
|
Service Code
|
NDC 68462058385
|
| Hospital Charge Code |
76843
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$680.10 |
| Max. Negotiated Rate |
$1,391.11 |
| Rate for Payer: Aetna American Axle |
$1,004.69
|
| Rate for Payer: Aetna Commercial |
$1,313.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.69
|
| Rate for Payer: Cash Price |
$1,236.54
|
| Rate for Payer: Cofinity Commercial |
$1,081.98
|
| Rate for Payer: Cofinity Commercial |
$1,329.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,081.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.54
|
| Rate for Payer: Healthscope Commercial |
$1,391.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,081.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.83
|
| Rate for Payer: PHP Commercial |
$1,313.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.69
|
| Rate for Payer: Priority Health SBD |
$973.78
|
| Rate for Payer: UMR Bronson Commercial |
$680.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.26
|
|
|
APREPITANT 40 MG CAPSULE
|
Facility
|
IP
|
$923.49
|
|
|
Service Code
|
NDC 13668059182
|
| Hospital Charge Code |
76843
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$406.34 |
| Max. Negotiated Rate |
$831.14 |
| Rate for Payer: Aetna American Axle |
$600.27
|
| Rate for Payer: Aetna Commercial |
$784.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.27
|
| Rate for Payer: Cash Price |
$738.79
|
| Rate for Payer: Cofinity Commercial |
$646.44
|
| Rate for Payer: Cofinity Commercial |
$794.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$646.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.79
|
| Rate for Payer: Healthscope Commercial |
$831.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$646.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.97
|
| Rate for Payer: PHP Commercial |
$784.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.27
|
| Rate for Payer: Priority Health SBD |
$581.80
|
| Rate for Payer: UMR Bronson Commercial |
$406.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.62
|
|
|
APREPITANT 40 MG CAPSULE
|
Facility
|
OP
|
$309.14
|
|
|
Service Code
|
NDC 68462058340
|
| Hospital Charge Code |
76843
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.38 |
| Max. Negotiated Rate |
$278.23 |
| Rate for Payer: Aetna American Axle |
$200.94
|
| Rate for Payer: Aetna Commercial |
$262.77
|
| Rate for Payer: Aetna Medicare |
$154.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.94
|
| Rate for Payer: BCBS Complete |
$123.66
|
| Rate for Payer: Cash Price |
$247.31
|
| Rate for Payer: Cofinity Commercial |
$216.40
|
| Rate for Payer: Cofinity Commercial |
$265.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.31
|
| Rate for Payer: Healthscope Commercial |
$278.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.77
|
| Rate for Payer: PHP Commercial |
$262.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.94
|
| Rate for Payer: Priority Health SBD |
$194.76
|
| Rate for Payer: UMR Bronson Commercial |
$114.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.85
|
|
|
APREPITANT 40 MG CAPSULE
|
Facility
|
OP
|
$173.76
|
|
|
Service Code
|
NDC 13668059180
|
| Hospital Charge Code |
76843
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.29 |
| Max. Negotiated Rate |
$156.38 |
| Rate for Payer: Aetna American Axle |
$112.94
|
| Rate for Payer: Aetna Commercial |
$147.70
|
| Rate for Payer: Aetna Medicare |
$86.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.94
|
| Rate for Payer: BCBS Complete |
$69.50
|
| Rate for Payer: Cash Price |
$139.01
|
| Rate for Payer: Cofinity Commercial |
$121.63
|
| Rate for Payer: Cofinity Commercial |
$149.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.01
|
| Rate for Payer: Healthscope Commercial |
$156.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.70
|
| Rate for Payer: PHP Commercial |
$147.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.94
|
| Rate for Payer: Priority Health SBD |
$109.47
|
| Rate for Payer: UMR Bronson Commercial |
$64.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.32
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
IP
|
$2,839.61
|
|
|
Service Code
|
NDC 00781232268
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,249.43 |
| Max. Negotiated Rate |
$2,555.65 |
| Rate for Payer: Aetna American Axle |
$1,845.75
|
| Rate for Payer: Aetna Commercial |
$2,413.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,845.75
|
| Rate for Payer: Cash Price |
$2,271.69
|
| Rate for Payer: Cofinity Commercial |
$1,987.73
|
| Rate for Payer: Cofinity Commercial |
$2,442.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,987.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,271.69
|
| Rate for Payer: Healthscope Commercial |
$2,555.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,987.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,129.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,413.67
|
| Rate for Payer: PHP Commercial |
$2,413.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,845.75
|
| Rate for Payer: Priority Health SBD |
$1,788.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,249.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,129.71
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
OP
|
$473.33
|
|
|
Service Code
|
NDC 00781232206
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.13 |
| Max. Negotiated Rate |
$426.00 |
| Rate for Payer: Aetna American Axle |
$307.66
|
| Rate for Payer: Aetna Commercial |
$402.33
|
| Rate for Payer: Aetna Medicare |
$236.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.66
|
| Rate for Payer: BCBS Complete |
$189.33
|
| Rate for Payer: Cash Price |
$378.66
|
| Rate for Payer: Cofinity Commercial |
$331.33
|
| Rate for Payer: Cofinity Commercial |
$407.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.66
|
| Rate for Payer: Healthscope Commercial |
$426.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.33
|
| Rate for Payer: PHP Commercial |
$402.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.66
|
| Rate for Payer: Priority Health SBD |
$298.20
|
| Rate for Payer: UMR Bronson Commercial |
$175.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.00
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
OP
|
$2,839.61
|
|
|
Service Code
|
NDC 00781232268
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,050.66 |
| Max. Negotiated Rate |
$2,555.65 |
| Rate for Payer: Aetna American Axle |
$1,845.75
|
| Rate for Payer: Aetna Commercial |
$2,413.67
|
| Rate for Payer: Aetna Medicare |
$1,419.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,845.75
|
| Rate for Payer: BCBS Complete |
$1,135.84
|
| Rate for Payer: Cash Price |
$2,271.69
|
| Rate for Payer: Cofinity Commercial |
$1,987.73
|
| Rate for Payer: Cofinity Commercial |
$2,442.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,987.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,271.69
|
| Rate for Payer: Healthscope Commercial |
$2,555.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,987.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,129.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,413.67
|
| Rate for Payer: PHP Commercial |
$2,413.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,845.75
|
| Rate for Payer: Priority Health SBD |
$1,788.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,050.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,129.71
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
IP
|
$473.33
|
|
|
Service Code
|
NDC 00781232206
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$208.27 |
| Max. Negotiated Rate |
$426.00 |
| Rate for Payer: Aetna American Axle |
$307.66
|
| Rate for Payer: Aetna Commercial |
$402.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.66
|
| Rate for Payer: Cash Price |
$378.66
|
| Rate for Payer: Cofinity Commercial |
$331.33
|
| Rate for Payer: Cofinity Commercial |
$407.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.66
|
| Rate for Payer: Healthscope Commercial |
$426.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.33
|
| Rate for Payer: PHP Commercial |
$402.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.66
|
| Rate for Payer: Priority Health SBD |
$298.20
|
| Rate for Payer: UMR Bronson Commercial |
$208.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.00
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
IP
|
$560.06
|
|
|
Service Code
|
NDC 09900001115
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$246.43 |
| Max. Negotiated Rate |
$504.05 |
| Rate for Payer: Aetna American Axle |
$364.04
|
| Rate for Payer: Aetna Commercial |
$476.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.04
|
| Rate for Payer: Cash Price |
$448.05
|
| Rate for Payer: Cofinity Commercial |
$392.04
|
| Rate for Payer: Cofinity Commercial |
$481.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$392.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.05
|
| Rate for Payer: Healthscope Commercial |
$504.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.05
|
| Rate for Payer: PHP Commercial |
$476.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.04
|
| Rate for Payer: Priority Health SBD |
$352.84
|
| Rate for Payer: UMR Bronson Commercial |
$246.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.05
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
OP
|
$1,505.42
|
|
|
Service Code
|
NDC 00006046102
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$557.01 |
| Max. Negotiated Rate |
$1,354.88 |
| Rate for Payer: Aetna American Axle |
$978.52
|
| Rate for Payer: Aetna Commercial |
$1,279.61
|
| Rate for Payer: Aetna Medicare |
$752.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$978.52
|
| Rate for Payer: BCBS Complete |
$602.17
|
| Rate for Payer: Cash Price |
$1,204.34
|
| Rate for Payer: Cofinity Commercial |
$1,053.79
|
| Rate for Payer: Cofinity Commercial |
$1,294.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,053.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,204.34
|
| Rate for Payer: Healthscope Commercial |
$1,354.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,053.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,129.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,279.61
|
| Rate for Payer: PHP Commercial |
$1,279.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$978.52
|
| Rate for Payer: Priority Health SBD |
$948.41
|
| Rate for Payer: UMR Bronson Commercial |
$557.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,129.07
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
IP
|
$946.65
|
|
|
Service Code
|
NDC 00781232246
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$416.53 |
| Max. Negotiated Rate |
$851.99 |
| Rate for Payer: Aetna American Axle |
$615.32
|
| Rate for Payer: Aetna Commercial |
$804.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.32
|
| Rate for Payer: Cash Price |
$757.32
|
| Rate for Payer: Cofinity Commercial |
$662.65
|
| Rate for Payer: Cofinity Commercial |
$814.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$662.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.32
|
| Rate for Payer: Healthscope Commercial |
$851.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$662.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$709.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.65
|
| Rate for Payer: PHP Commercial |
$804.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.32
|
| Rate for Payer: Priority Health SBD |
$596.39
|
| Rate for Payer: UMR Bronson Commercial |
$416.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$709.99
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
OP
|
$946.65
|
|
|
Service Code
|
NDC 00781232246
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$350.26 |
| Max. Negotiated Rate |
$851.99 |
| Rate for Payer: Aetna American Axle |
$615.32
|
| Rate for Payer: Aetna Commercial |
$804.65
|
| Rate for Payer: Aetna Medicare |
$473.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.32
|
| Rate for Payer: BCBS Complete |
$378.66
|
| Rate for Payer: Cash Price |
$757.32
|
| Rate for Payer: Cofinity Commercial |
$662.65
|
| Rate for Payer: Cofinity Commercial |
$814.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$662.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.32
|
| Rate for Payer: Healthscope Commercial |
$851.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$662.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$709.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.65
|
| Rate for Payer: PHP Commercial |
$804.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.32
|
| Rate for Payer: Priority Health SBD |
$596.39
|
| Rate for Payer: UMR Bronson Commercial |
$350.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$709.99
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
OP
|
$560.06
|
|
|
Service Code
|
NDC 09900001115
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$207.22 |
| Max. Negotiated Rate |
$504.05 |
| Rate for Payer: Aetna American Axle |
$364.04
|
| Rate for Payer: Aetna Commercial |
$476.05
|
| Rate for Payer: Aetna Medicare |
$280.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.04
|
| Rate for Payer: BCBS Complete |
$224.02
|
| Rate for Payer: Cash Price |
$448.05
|
| Rate for Payer: Cofinity Commercial |
$392.04
|
| Rate for Payer: Cofinity Commercial |
$481.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$392.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.05
|
| Rate for Payer: Healthscope Commercial |
$504.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.05
|
| Rate for Payer: PHP Commercial |
$476.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.04
|
| Rate for Payer: Priority Health SBD |
$352.84
|
| Rate for Payer: UMR Bronson Commercial |
$207.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.05
|
|
|
APREPITANT 80 MG CAPSULE
|
Facility
|
IP
|
$1,505.42
|
|
|
Service Code
|
NDC 00006046102
|
| Hospital Charge Code |
35488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$662.38 |
| Max. Negotiated Rate |
$1,354.88 |
| Rate for Payer: Aetna American Axle |
$978.52
|
| Rate for Payer: Aetna Commercial |
$1,279.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$978.52
|
| Rate for Payer: Cash Price |
$1,204.34
|
| Rate for Payer: Cofinity Commercial |
$1,053.79
|
| Rate for Payer: Cofinity Commercial |
$1,294.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,053.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,204.34
|
| Rate for Payer: Healthscope Commercial |
$1,354.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,053.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,129.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,279.61
|
| Rate for Payer: PHP Commercial |
$1,279.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$978.52
|
| Rate for Payer: Priority Health SBD |
$948.41
|
| Rate for Payer: UMR Bronson Commercial |
$662.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,129.07
|
|
|
AQUEOUS SHUNT TO EXTRAOCULAR EQUATORIAL PLATE RESERVOIR, EXTERNAL APPROACH; WITH GRAFT
|
Facility
|
OP
|
$14,165.03
|
|
|
Service Code
|
CPT 66180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,697.24 |
| Max. Negotiated Rate |
$14,165.03 |
| Rate for Payer: Aetna Medicare |
$5,233.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,290.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,290.20
|
| Rate for Payer: BCBS Complete |
$2,832.10
|
| Rate for Payer: BCBS MAPPO |
$5,032.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,032.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,032.16
|
| Rate for Payer: Mclaren Medicaid |
$2,697.24
|
| Rate for Payer: Mclaren Medicare |
$5,032.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,283.77
|
| Rate for Payer: Meridian Medicaid |
$2,832.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,786.98
|
| Rate for Payer: PACE Medicare |
$4,780.55
|
| Rate for Payer: PACE SWMI |
$5,032.16
|
| Rate for Payer: PHP Medicare Advantage |
$5,032.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,697.24
|
| Rate for Payer: Priority Health Medicare |
$5,032.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5,032.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,165.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,032.16
|
| Rate for Payer: UHC Exchange |
$9,616.96
|
| Rate for Payer: UHC Medicare Advantage |
$5,032.16
|
| Rate for Payer: UHCCP Medicaid |
$2,697.24
|
| Rate for Payer: VA VA |
$5,032.16
|
|
|
ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$8.03
|
|
|
Service Code
|
HCPCS J7605
|
| Hospital Charge Code |
77581
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$7.23 |
| Rate for Payer: Aetna American Axle |
$5.22
|
| Rate for Payer: Aetna American Axle |
$10.52
|
| Rate for Payer: Aetna American Axle |
$14.35
|
| Rate for Payer: Aetna American Axle |
$5.60
|
| Rate for Payer: Aetna American Axle |
$16.40
|
| Rate for Payer: Aetna Commercial |
$6.83
|
| Rate for Payer: Aetna Commercial |
$18.77
|
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$7.32
|
| Rate for Payer: Aetna Commercial |
$21.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cash Price |
$6.89
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cash Price |
$20.18
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$6.03
|
| Rate for Payer: Cofinity Commercial |
$11.33
|
| Rate for Payer: Cofinity Commercial |
$6.91
|
| Rate for Payer: Cofinity Commercial |
$5.62
|
| Rate for Payer: Cofinity Commercial |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Commercial |
$18.99
|
| Rate for Payer: Cofinity Commercial |
$21.70
|
| Rate for Payer: Cofinity Commercial |
$13.92
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.18
|
| Rate for Payer: Healthscope Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$7.23
|
| Rate for Payer: Healthscope Commercial |
$22.71
|
| Rate for Payer: Healthscope Commercial |
$7.75
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: PHP Commercial |
$13.76
|
| Rate for Payer: PHP Commercial |
$7.32
|
| Rate for Payer: PHP Commercial |
$21.45
|
| Rate for Payer: PHP Commercial |
$6.83
|
| Rate for Payer: PHP Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.52
|
| Rate for Payer: Priority Health SBD |
$5.42
|
| Rate for Payer: Priority Health SBD |
$15.89
|
| Rate for Payer: Priority Health SBD |
$13.91
|
| Rate for Payer: Priority Health SBD |
$10.20
|
| Rate for Payer: Priority Health SBD |
$5.06
|
| Rate for Payer: UMR Bronson Commercial |
$7.12
|
| Rate for Payer: UMR Bronson Commercial |
$9.72
|
| Rate for Payer: UMR Bronson Commercial |
$3.53
|
| Rate for Payer: UMR Bronson Commercial |
$3.79
|
| Rate for Payer: UMR Bronson Commercial |
$11.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.02
|
|
|
ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION
|
Facility
|
OP
|
$22.08
|
|
|
Service Code
|
HCPCS J7605
|
| Hospital Charge Code |
77581
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$19.87 |
| Rate for Payer: Aetna American Axle |
$14.35
|
| Rate for Payer: Aetna American Axle |
$5.22
|
| Rate for Payer: Aetna American Axle |
$5.60
|
| Rate for Payer: Aetna American Axle |
$10.52
|
| Rate for Payer: Aetna American Axle |
$16.40
|
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$7.32
|
| Rate for Payer: Aetna Commercial |
$21.45
|
| Rate for Payer: Aetna Commercial |
$6.83
|
| Rate for Payer: Aetna Commercial |
$18.77
|
| Rate for Payer: Aetna Medicare |
$4.01
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Aetna Medicare |
$4.30
|
| Rate for Payer: Aetna Medicare |
$12.62
|
| Rate for Payer: Aetna Medicare |
$8.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.22
|
| Rate for Payer: BCBS Complete |
$3.44
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS Complete |
$3.21
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: Cash Price |
$6.89
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cash Price |
$20.18
|
| Rate for Payer: Cofinity Commercial |
$6.03
|
| Rate for Payer: Cofinity Commercial |
$18.99
|
| Rate for Payer: Cofinity Commercial |
$6.91
|
| Rate for Payer: Cofinity Commercial |
$11.33
|
| Rate for Payer: Cofinity Commercial |
$21.70
|
| Rate for Payer: Cofinity Commercial |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$5.62
|
| Rate for Payer: Cofinity Commercial |
$13.92
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.18
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$22.71
|
| Rate for Payer: Healthscope Commercial |
$7.75
|
| Rate for Payer: Healthscope Commercial |
$7.23
|
| Rate for Payer: Healthscope Commercial |
$19.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.32
|
| Rate for Payer: PHP Commercial |
$6.83
|
| Rate for Payer: PHP Commercial |
$21.45
|
| Rate for Payer: PHP Commercial |
$13.76
|
| Rate for Payer: PHP Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$7.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.35
|
| Rate for Payer: Priority Health SBD |
$13.91
|
| Rate for Payer: Priority Health SBD |
$10.20
|
| Rate for Payer: Priority Health SBD |
$15.89
|
| Rate for Payer: Priority Health SBD |
$5.06
|
| Rate for Payer: Priority Health SBD |
$5.42
|
| Rate for Payer: UMR Bronson Commercial |
$3.19
|
| Rate for Payer: UMR Bronson Commercial |
$2.97
|
| Rate for Payer: UMR Bronson Commercial |
$8.17
|
| Rate for Payer: UMR Bronson Commercial |
$5.99
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.92
|
|
|
ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$427.67
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
28947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.17 |
| Max. Negotiated Rate |
$384.90 |
| Rate for Payer: Aetna American Axle |
$277.99
|
| Rate for Payer: Aetna American Axle |
$257.52
|
| Rate for Payer: Aetna American Axle |
$118.03
|
| Rate for Payer: Aetna American Axle |
$442.05
|
| Rate for Payer: Aetna Commercial |
$363.52
|
| Rate for Payer: Aetna Commercial |
$578.07
|
| Rate for Payer: Aetna Commercial |
$336.75
|
| Rate for Payer: Aetna Commercial |
$154.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cofinity Commercial |
$127.11
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Cofinity Commercial |
$476.06
|
| Rate for Payer: Cofinity Commercial |
$299.37
|
| Rate for Payer: Cofinity Commercial |
$277.33
|
| Rate for Payer: Cofinity Commercial |
$340.71
|
| Rate for Payer: Cofinity Commercial |
$367.80
|
| Rate for Payer: Cofinity Commercial |
$156.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.94
|
| Rate for Payer: Healthscope Commercial |
$384.90
|
| Rate for Payer: Healthscope Commercial |
$163.43
|
| Rate for Payer: Healthscope Commercial |
$356.56
|
| Rate for Payer: Healthscope Commercial |
$612.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.52
|
| Rate for Payer: PHP Commercial |
$363.52
|
| Rate for Payer: PHP Commercial |
$578.07
|
| Rate for Payer: PHP Commercial |
$154.35
|
| Rate for Payer: PHP Commercial |
$336.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.03
|
| Rate for Payer: Priority Health SBD |
$428.45
|
| Rate for Payer: Priority Health SBD |
$114.40
|
| Rate for Payer: Priority Health SBD |
$249.59
|
| Rate for Payer: Priority Health SBD |
$269.43
|
| Rate for Payer: UMR Bronson Commercial |
$188.17
|
| Rate for Payer: UMR Bronson Commercial |
$299.24
|
| Rate for Payer: UMR Bronson Commercial |
$174.32
|
| Rate for Payer: UMR Bronson Commercial |
$79.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.75
|
|
|
ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$181.59
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
28947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$163.43 |
| Rate for Payer: Aetna American Axle |
$118.03
|
| Rate for Payer: Aetna American Axle |
$257.52
|
| Rate for Payer: Aetna American Axle |
$442.05
|
| Rate for Payer: Aetna American Axle |
$277.99
|
| Rate for Payer: Aetna Commercial |
$578.07
|
| Rate for Payer: Aetna Commercial |
$154.35
|
| Rate for Payer: Aetna Commercial |
$336.75
|
| Rate for Payer: Aetna Commercial |
$363.52
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cofinity Commercial |
$340.71
|
| Rate for Payer: Cofinity Commercial |
$127.11
|
| Rate for Payer: Cofinity Commercial |
$156.17
|
| Rate for Payer: Cofinity Commercial |
$277.33
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Cofinity Commercial |
$476.06
|
| Rate for Payer: Cofinity Commercial |
$299.37
|
| Rate for Payer: Cofinity Commercial |
$367.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$127.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Healthscope Commercial |
$163.43
|
| Rate for Payer: Healthscope Commercial |
$356.56
|
| Rate for Payer: Healthscope Commercial |
$612.07
|
| Rate for Payer: Healthscope Commercial |
$384.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.75
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.52
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PHP Commercial |
$363.52
|
| Rate for Payer: PHP Commercial |
$154.35
|
| Rate for Payer: PHP Commercial |
$336.75
|
| Rate for Payer: PHP Commercial |
$578.07
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.52
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health SBD |
$249.59
|
| Rate for Payer: Priority Health SBD |
$269.43
|
| Rate for Payer: Priority Health SBD |
$114.40
|
| Rate for Payer: Priority Health SBD |
$428.45
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
| Rate for Payer: UMR Bronson Commercial |
$146.59
|
| Rate for Payer: UMR Bronson Commercial |
$67.19
|
| Rate for Payer: UMR Bronson Commercial |
$251.63
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.06
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$432.68
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$389.41 |
| Rate for Payer: Aetna American Axle |
$281.24
|
| Rate for Payer: Aetna American Axle |
$278.82
|
| Rate for Payer: Aetna American Axle |
$216.40
|
| Rate for Payer: Aetna Commercial |
$367.78
|
| Rate for Payer: Aetna Commercial |
$282.98
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna Medicare |
$0.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.00
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.80
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cofinity Commercial |
$233.04
|
| Rate for Payer: Cofinity Commercial |
$372.10
|
| Rate for Payer: Cofinity Commercial |
$302.88
|
| Rate for Payer: Cofinity Commercial |
$300.27
|
| Rate for Payer: Cofinity Commercial |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.80
|
| Rate for Payer: Healthscope Commercial |
$299.63
|
| Rate for Payer: Healthscope Commercial |
$389.41
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.72
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Mclaren Medicare |
$0.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.84
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.98
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE Medicare |
$0.76
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PACE SWMI |
$0.80
|
| Rate for Payer: PHP Commercial |
$367.78
|
| Rate for Payer: PHP Commercial |
$282.98
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: PHP Medicare Advantage |
$0.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.80
|
| Rate for Payer: Priority Health SBD |
$209.74
|
| Rate for Payer: Priority Health SBD |
$270.24
|
| Rate for Payer: Priority Health SBD |
$272.59
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.80
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Exchange |
$1.53
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$0.80
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$158.72
|
| Rate for Payer: UMR Bronson Commercial |
$160.09
|
| Rate for Payer: UMR Bronson Commercial |
$123.18
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: VA VA |
$0.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.69
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$351.02
|
|
|
Service Code
|
HCPCS J0898
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$154.45 |
| Max. Negotiated Rate |
$315.92 |
| Rate for Payer: Aetna American Axle |
$228.16
|
| Rate for Payer: Aetna Commercial |
$298.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.16
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Commercial |
$245.71
|
| Rate for Payer: Cofinity Commercial |
$301.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Healthscope Commercial |
$315.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: PHP Commercial |
$298.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.16
|
| Rate for Payer: Priority Health SBD |
$221.14
|
| Rate for Payer: UMR Bronson Commercial |
$154.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.26
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$442.43
|
|
|
Service Code
|
HCPCS J0891
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$194.67 |
| Max. Negotiated Rate |
$398.19 |
| Rate for Payer: Aetna American Axle |
$287.58
|
| Rate for Payer: Aetna Commercial |
$376.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.58
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cofinity Commercial |
$309.70
|
| Rate for Payer: Cofinity Commercial |
$380.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.94
|
| Rate for Payer: Healthscope Commercial |
$398.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.07
|
| Rate for Payer: PHP Commercial |
$376.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.58
|
| Rate for Payer: Priority Health SBD |
$278.73
|
| Rate for Payer: UMR Bronson Commercial |
$194.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.82
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$332.92
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.48 |
| Max. Negotiated Rate |
$299.63 |
| Rate for Payer: Aetna American Axle |
$216.40
|
| Rate for Payer: Aetna American Axle |
$278.82
|
| Rate for Payer: Aetna American Axle |
$281.24
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Commercial |
$282.98
|
| Rate for Payer: Aetna Commercial |
$367.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.82
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Cofinity Commercial |
$300.27
|
| Rate for Payer: Cofinity Commercial |
$372.10
|
| Rate for Payer: Cofinity Commercial |
$302.88
|
| Rate for Payer: Cofinity Commercial |
$233.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$302.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.17
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Healthscope Commercial |
$299.63
|
| Rate for Payer: Healthscope Commercial |
$389.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: PHP Commercial |
$367.78
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Commercial |
$282.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health SBD |
$272.59
|
| Rate for Payer: Priority Health SBD |
$270.24
|
| Rate for Payer: Priority Health SBD |
$209.74
|
| Rate for Payer: UMR Bronson Commercial |
$146.48
|
| Rate for Payer: UMR Bronson Commercial |
$190.38
|
| Rate for Payer: UMR Bronson Commercial |
$188.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.72
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$442.43
|
|
|
Service Code
|
HCPCS J0891
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$398.19 |
| Rate for Payer: Aetna American Axle |
$287.58
|
| Rate for Payer: Aetna Commercial |
$376.07
|
| Rate for Payer: Aetna Medicare |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.27
|
| Rate for Payer: BCBS Complete |
$1.02
|
| Rate for Payer: BCBS MAPPO |
$1.82
|
| Rate for Payer: BCN Medicare Advantage |
$1.82
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cofinity Commercial |
$380.49
|
| Rate for Payer: Cofinity Commercial |
$309.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$398.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.82
|
| Rate for Payer: Mclaren Medicaid |
$0.98
|
| Rate for Payer: Mclaren Medicare |
$1.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.91
|
| Rate for Payer: Meridian Medicaid |
$1.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.07
|
| Rate for Payer: PACE Medicare |
$1.73
|
| Rate for Payer: PACE SWMI |
$1.82
|
| Rate for Payer: PHP Commercial |
$376.07
|
| Rate for Payer: PHP Medicare Advantage |
$1.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.58
|
| Rate for Payer: Priority Health Medicare |
$1.82
|
| Rate for Payer: Priority Health SBD |
$278.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.82
|
| Rate for Payer: UHC Exchange |
$3.48
|
| Rate for Payer: UHC Medicare Advantage |
$1.82
|
| Rate for Payer: UHCCP Medicaid |
$0.98
|
| Rate for Payer: UMR Bronson Commercial |
$163.70
|
| Rate for Payer: VA VA |
$1.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.82
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$351.02
|
|
|
Service Code
|
HCPCS J0898
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$315.92 |
| Rate for Payer: Aetna American Axle |
$228.16
|
| Rate for Payer: Aetna Commercial |
$298.37
|
| Rate for Payer: Aetna Medicare |
$1.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.02
|
| Rate for Payer: BCBS Complete |
$0.91
|
| Rate for Payer: BCBS MAPPO |
$1.62
|
| Rate for Payer: BCN Medicare Advantage |
$1.62
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Commercial |
$301.88
|
| Rate for Payer: Cofinity Commercial |
$245.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.62
|
| Rate for Payer: Healthscope Commercial |
$315.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.26
|
| Rate for Payer: Mclaren Medicaid |
$0.87
|
| Rate for Payer: Mclaren Medicare |
$1.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.70
|
| Rate for Payer: Meridian Medicaid |
$0.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: PACE Medicare |
$1.54
|
| Rate for Payer: PACE SWMI |
$1.62
|
| Rate for Payer: PHP Commercial |
$298.37
|
| Rate for Payer: PHP Medicare Advantage |
$1.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.16
|
| Rate for Payer: Priority Health Medicare |
$1.62
|
| Rate for Payer: Priority Health SBD |
$221.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.62
|
| Rate for Payer: UHC Exchange |
$3.10
|
| Rate for Payer: UHC Medicare Advantage |
$1.62
|
| Rate for Payer: UHCCP Medicaid |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$129.88
|
| Rate for Payer: VA VA |
$1.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.26
|
|
