|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
OP
|
$431.04
|
|
|
Service Code
|
NDC 43386016101
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$159.48 |
| Max. Negotiated Rate |
$387.94 |
| Rate for Payer: Aetna American Axle |
$280.18
|
| Rate for Payer: Aetna Commercial |
$366.38
|
| Rate for Payer: Aetna Medicare |
$215.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.18
|
| Rate for Payer: BCBS Complete |
$172.42
|
| Rate for Payer: Cash Price |
$344.83
|
| Rate for Payer: Cofinity Advantage |
$301.73
|
| Rate for Payer: Cofinity Commercial |
$370.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.83
|
| Rate for Payer: Healthscope Commercial |
$387.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.28
|
| Rate for Payer: PHP Commercial |
$366.38
|
| Rate for Payer: Priority Health SBD |
$271.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.18
|
| Rate for Payer: UHC Core |
$224.57
|
| Rate for Payer: UHC Exchange |
$169.40
|
| Rate for Payer: UMR Bronson Commercial |
$159.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.28
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$258.63
|
|
|
Service Code
|
NDC 59762500801
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.80 |
| Max. Negotiated Rate |
$232.77 |
| Rate for Payer: Aetna American Axle |
$168.11
|
| Rate for Payer: Aetna Commercial |
$219.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.11
|
| Rate for Payer: Cash Price |
$206.90
|
| Rate for Payer: Cofinity Advantage |
$181.04
|
| Rate for Payer: Cofinity Commercial |
$222.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.90
|
| Rate for Payer: Healthscope Commercial |
$232.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.97
|
| Rate for Payer: PHP Commercial |
$219.84
|
| Rate for Payer: Priority Health SBD |
$162.94
|
| Rate for Payer: UMR Bronson Commercial |
$113.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.97
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$794.88
|
|
|
Service Code
|
NDC 68084004101
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$349.75 |
| Max. Negotiated Rate |
$715.39 |
| Rate for Payer: Aetna American Axle |
$516.67
|
| Rate for Payer: Aetna Commercial |
$675.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.67
|
| Rate for Payer: Cash Price |
$635.90
|
| Rate for Payer: Cofinity Advantage |
$556.42
|
| Rate for Payer: Cofinity Commercial |
$683.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$635.90
|
| Rate for Payer: Healthscope Commercial |
$715.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$675.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.16
|
| Rate for Payer: PHP Commercial |
$675.65
|
| Rate for Payer: Priority Health SBD |
$500.77
|
| Rate for Payer: UMR Bronson Commercial |
$349.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.16
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
OP
|
$794.88
|
|
|
Service Code
|
NDC 68084004101
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$294.11 |
| Max. Negotiated Rate |
$715.39 |
| Rate for Payer: Aetna American Axle |
$516.67
|
| Rate for Payer: Aetna Commercial |
$675.65
|
| Rate for Payer: Aetna Medicare |
$397.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.67
|
| Rate for Payer: BCBS Complete |
$317.95
|
| Rate for Payer: Cash Price |
$635.90
|
| Rate for Payer: Cofinity Advantage |
$556.42
|
| Rate for Payer: Cofinity Commercial |
$683.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$635.90
|
| Rate for Payer: Healthscope Commercial |
$715.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$635.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$675.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.16
|
| Rate for Payer: PHP Commercial |
$675.65
|
| Rate for Payer: Priority Health SBD |
$500.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.67
|
| Rate for Payer: UHC Core |
$414.13
|
| Rate for Payer: UHC Exchange |
$312.39
|
| Rate for Payer: UMR Bronson Commercial |
$294.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.16
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
OP
|
$431.04
|
|
|
Service Code
|
NDC 59762500802
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$159.48 |
| Max. Negotiated Rate |
$387.94 |
| Rate for Payer: Aetna American Axle |
$280.18
|
| Rate for Payer: Aetna Commercial |
$366.38
|
| Rate for Payer: Aetna Medicare |
$215.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.18
|
| Rate for Payer: BCBS Complete |
$172.42
|
| Rate for Payer: Cash Price |
$344.83
|
| Rate for Payer: Cofinity Advantage |
$301.73
|
| Rate for Payer: Cofinity Commercial |
$370.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.83
|
| Rate for Payer: Healthscope Commercial |
$387.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.28
|
| Rate for Payer: PHP Commercial |
$366.38
|
| Rate for Payer: Priority Health SBD |
$271.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.18
|
| Rate for Payer: UHC Core |
$224.57
|
| Rate for Payer: UHC Exchange |
$169.40
|
| Rate for Payer: UMR Bronson Commercial |
$159.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.28
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
OP
|
$390.72
|
|
|
Service Code
|
NDC 70954044420
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.57 |
| Max. Negotiated Rate |
$351.65 |
| Rate for Payer: Aetna American Axle |
$253.97
|
| Rate for Payer: Aetna Commercial |
$332.11
|
| Rate for Payer: Aetna Medicare |
$195.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.97
|
| Rate for Payer: BCBS Complete |
$156.29
|
| Rate for Payer: Cash Price |
$312.58
|
| Rate for Payer: Cofinity Advantage |
$273.50
|
| Rate for Payer: Cofinity Commercial |
$336.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.58
|
| Rate for Payer: Healthscope Commercial |
$351.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$293.04
|
| Rate for Payer: PHP Commercial |
$332.11
|
| Rate for Payer: Priority Health SBD |
$246.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.97
|
| Rate for Payer: UHC Core |
$203.57
|
| Rate for Payer: UHC Exchange |
$153.55
|
| Rate for Payer: UMR Bronson Commercial |
$144.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.04
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$431.04
|
|
|
Service Code
|
NDC 43386016101
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$189.66 |
| Max. Negotiated Rate |
$387.94 |
| Rate for Payer: Aetna American Axle |
$280.18
|
| Rate for Payer: Aetna Commercial |
$366.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.18
|
| Rate for Payer: Cash Price |
$344.83
|
| Rate for Payer: Cofinity Advantage |
$301.73
|
| Rate for Payer: Cofinity Commercial |
$370.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.83
|
| Rate for Payer: Healthscope Commercial |
$387.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.28
|
| Rate for Payer: PHP Commercial |
$366.38
|
| Rate for Payer: Priority Health SBD |
$271.56
|
| Rate for Payer: UMR Bronson Commercial |
$189.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.28
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$390.72
|
|
|
Service Code
|
NDC 70954044420
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$171.92 |
| Max. Negotiated Rate |
$351.65 |
| Rate for Payer: Aetna American Axle |
$253.97
|
| Rate for Payer: Aetna Commercial |
$332.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.97
|
| Rate for Payer: Cash Price |
$312.58
|
| Rate for Payer: Cofinity Advantage |
$273.50
|
| Rate for Payer: Cofinity Commercial |
$336.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.58
|
| Rate for Payer: Healthscope Commercial |
$351.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$293.04
|
| Rate for Payer: PHP Commercial |
$332.11
|
| Rate for Payer: Priority Health SBD |
$246.15
|
| Rate for Payer: UMR Bronson Commercial |
$171.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.04
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$7.95
|
|
|
Service Code
|
NDC 68084004111
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$7.16 |
| Rate for Payer: Aetna American Axle |
$5.17
|
| Rate for Payer: Aetna Commercial |
$6.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.17
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cofinity Advantage |
$5.57
|
| Rate for Payer: Cofinity Commercial |
$6.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.36
|
| Rate for Payer: Healthscope Commercial |
$7.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.96
|
| Rate for Payer: PHP Commercial |
$6.76
|
| Rate for Payer: Priority Health SBD |
$5.01
|
| Rate for Payer: UMR Bronson Commercial |
$3.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
|
|
MISOPROSTOL 200 MCG TABLET
|
Facility
|
IP
|
$431.04
|
|
|
Service Code
|
NDC 59762500802
|
| Hospital Charge Code |
10629
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$189.66 |
| Max. Negotiated Rate |
$387.94 |
| Rate for Payer: Aetna American Axle |
$280.18
|
| Rate for Payer: Aetna Commercial |
$366.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.18
|
| Rate for Payer: Cash Price |
$344.83
|
| Rate for Payer: Cofinity Advantage |
$301.73
|
| Rate for Payer: Cofinity Commercial |
$370.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.83
|
| Rate for Payer: Healthscope Commercial |
$387.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.28
|
| Rate for Payer: PHP Commercial |
$366.38
|
| Rate for Payer: Priority Health SBD |
$271.56
|
| Rate for Payer: UMR Bronson Commercial |
$189.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.28
|
|
|
MISOPROSTOL 25 MCG CUSTOM TAB
|
Facility
|
OP
|
$1,442.63
|
|
|
Service Code
|
NDC 09900000016
|
| Hospital Charge Code |
150707
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$533.77 |
| Max. Negotiated Rate |
$1,298.37 |
| Rate for Payer: Aetna American Axle |
$937.71
|
| Rate for Payer: Aetna Commercial |
$1,226.24
|
| Rate for Payer: Aetna Medicare |
$721.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.71
|
| Rate for Payer: BCBS Complete |
$577.05
|
| Rate for Payer: Cash Price |
$1,154.10
|
| Rate for Payer: Cofinity Advantage |
$1,009.84
|
| Rate for Payer: Cofinity Commercial |
$1,240.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.10
|
| Rate for Payer: Healthscope Commercial |
$1,298.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,009.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,081.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,154.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,081.97
|
| Rate for Payer: PHP Commercial |
$1,226.24
|
| Rate for Payer: Priority Health SBD |
$908.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.71
|
| Rate for Payer: UHC Core |
$751.61
|
| Rate for Payer: UHC Exchange |
$566.95
|
| Rate for Payer: UMR Bronson Commercial |
$533.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,081.97
|
|
|
MISOPROSTOL 25 MCG CUSTOM TAB
|
Facility
|
IP
|
$1,442.63
|
|
|
Service Code
|
NDC 09900000016
|
| Hospital Charge Code |
150707
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$634.76 |
| Max. Negotiated Rate |
$1,298.37 |
| Rate for Payer: Aetna American Axle |
$937.71
|
| Rate for Payer: Aetna Commercial |
$1,226.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.71
|
| Rate for Payer: Cash Price |
$1,154.10
|
| Rate for Payer: Cofinity Advantage |
$1,009.84
|
| Rate for Payer: Cofinity Commercial |
$1,240.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.10
|
| Rate for Payer: Healthscope Commercial |
$1,298.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,009.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,081.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,081.97
|
| Rate for Payer: PHP Commercial |
$1,226.24
|
| Rate for Payer: Priority Health SBD |
$908.86
|
| Rate for Payer: UMR Bronson Commercial |
$634.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,081.97
|
|
|
MITOMYCIN 0.2 MG/ML OCULAR SOLUTION
|
Facility
|
IP
|
$65.52
|
|
|
Service Code
|
HCPCS J7315
|
| Hospital Charge Code |
151070
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.83 |
| Max. Negotiated Rate |
$58.97 |
| Rate for Payer: Aetna American Axle |
$42.59
|
| Rate for Payer: Aetna Commercial |
$55.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.59
|
| Rate for Payer: Cash Price |
$52.42
|
| Rate for Payer: Cofinity Advantage |
$45.86
|
| Rate for Payer: Cofinity Commercial |
$56.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.42
|
| Rate for Payer: Healthscope Commercial |
$58.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.14
|
| Rate for Payer: PHP Commercial |
$55.69
|
| Rate for Payer: Priority Health SBD |
$41.28
|
| Rate for Payer: UMR Bronson Commercial |
$28.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.14
|
|
|
MITOMYCIN 0.2 MG/ML OCULAR SOLUTION
|
Facility
|
OP
|
$65.52
|
|
|
Service Code
|
HCPCS J7315
|
| Hospital Charge Code |
151070
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.24 |
| Max. Negotiated Rate |
$1,139.18 |
| Rate for Payer: Aetna American Axle |
$42.59
|
| Rate for Payer: Aetna Commercial |
$55.69
|
| Rate for Payer: Aetna Medicare |
$32.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.59
|
| Rate for Payer: BCBS Complete |
$26.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,139.18
|
| Rate for Payer: BCN Commercial |
$1,139.18
|
| Rate for Payer: Cash Price |
$52.42
|
| Rate for Payer: Cash Price |
$52.42
|
| Rate for Payer: Cofinity Advantage |
$45.86
|
| Rate for Payer: Cofinity Commercial |
$56.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.42
|
| Rate for Payer: Healthscope Commercial |
$58.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.14
|
| Rate for Payer: PHP Commercial |
$55.69
|
| Rate for Payer: Priority Health SBD |
$41.28
|
| Rate for Payer: UMR Bronson Commercial |
$24.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.14
|
|
|
MITOMYCIN 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$770.95
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10630
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$693.86 |
| Rate for Payer: Aetna American Axle |
$501.12
|
| Rate for Payer: Aetna American Axle |
$671.00
|
| Rate for Payer: Aetna American Axle |
$301.41
|
| Rate for Payer: Aetna Commercial |
$655.31
|
| Rate for Payer: Aetna Commercial |
$394.15
|
| Rate for Payer: Aetna Commercial |
$877.46
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$370.97
|
| Rate for Payer: Cash Price |
$616.76
|
| Rate for Payer: Cash Price |
$825.84
|
| Rate for Payer: Cash Price |
$616.76
|
| Rate for Payer: Cash Price |
$370.97
|
| Rate for Payer: Cash Price |
$825.84
|
| Rate for Payer: Cofinity Advantage |
$722.61
|
| Rate for Payer: Cofinity Advantage |
$324.60
|
| Rate for Payer: Cofinity Advantage |
$539.66
|
| Rate for Payer: Cofinity Commercial |
$398.79
|
| Rate for Payer: Cofinity Commercial |
$663.02
|
| Rate for Payer: Cofinity Commercial |
$887.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$929.07
|
| Rate for Payer: Healthscope Commercial |
$417.34
|
| Rate for Payer: Healthscope Commercial |
$693.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$539.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$578.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.23
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$877.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.31
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.21
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$655.31
|
| Rate for Payer: PHP Commercial |
$877.46
|
| Rate for Payer: PHP Commercial |
$394.15
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health SBD |
$485.70
|
| Rate for Payer: Priority Health SBD |
$292.14
|
| Rate for Payer: Priority Health SBD |
$650.35
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$171.57
|
| Rate for Payer: UMR Bronson Commercial |
$381.95
|
| Rate for Payer: UMR Bronson Commercial |
$285.25
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$578.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.78
|
|
|
MITOMYCIN 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$463.71
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10630
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$204.03 |
| Max. Negotiated Rate |
$417.34 |
| Rate for Payer: Aetna American Axle |
$301.41
|
| Rate for Payer: Aetna American Axle |
$501.12
|
| Rate for Payer: Aetna Commercial |
$394.15
|
| Rate for Payer: Aetna Commercial |
$655.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.12
|
| Rate for Payer: Cash Price |
$370.97
|
| Rate for Payer: Cash Price |
$616.76
|
| Rate for Payer: Cofinity Advantage |
$539.66
|
| Rate for Payer: Cofinity Advantage |
$324.60
|
| Rate for Payer: Cofinity Commercial |
$663.02
|
| Rate for Payer: Cofinity Commercial |
$398.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.76
|
| Rate for Payer: Healthscope Commercial |
$417.34
|
| Rate for Payer: Healthscope Commercial |
$693.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$539.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$578.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.21
|
| Rate for Payer: PHP Commercial |
$394.15
|
| Rate for Payer: PHP Commercial |
$655.31
|
| Rate for Payer: Priority Health SBD |
$485.70
|
| Rate for Payer: Priority Health SBD |
$292.14
|
| Rate for Payer: UMR Bronson Commercial |
$204.03
|
| Rate for Payer: UMR Bronson Commercial |
$339.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$578.21
|
|
|
MITOMYCIN 20 MG SOLUTION FOR BLADDER IRRIGATION (CUSTOM)
|
Facility
|
OP
|
$770.95
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
300956
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$693.86 |
| Rate for Payer: Aetna American Axle |
$501.12
|
| Rate for Payer: Aetna Commercial |
$655.31
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$616.76
|
| Rate for Payer: Cash Price |
$616.76
|
| Rate for Payer: Cofinity Advantage |
$539.66
|
| Rate for Payer: Cofinity Commercial |
$663.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$693.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$539.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$578.21
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.31
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.21
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$655.31
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health SBD |
$485.70
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$285.25
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$578.21
|
|
|
MITOMYCIN 40 MG/20 ML BLADDER FOR IRRIGATION SOLUTION CUSTOM
|
Facility
|
OP
|
$927.32
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
301471
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$834.59 |
| Rate for Payer: Aetna American Axle |
$602.76
|
| Rate for Payer: Aetna American Axle |
$3,650.32
|
| Rate for Payer: Aetna Commercial |
$4,773.49
|
| Rate for Payer: Aetna Commercial |
$788.22
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,650.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cofinity Advantage |
$649.12
|
| Rate for Payer: Cofinity Advantage |
$3,931.11
|
| Rate for Payer: Cofinity Commercial |
$4,829.65
|
| Rate for Payer: Cofinity Commercial |
$797.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$5,054.28
|
| Rate for Payer: Healthscope Commercial |
$834.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,931.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,211.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.49
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.22
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$695.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,211.90
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$4,773.49
|
| Rate for Payer: PHP Commercial |
$788.22
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health SBD |
$3,538.00
|
| Rate for Payer: Priority Health SBD |
$584.21
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$2,077.87
|
| Rate for Payer: UMR Bronson Commercial |
$343.11
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,211.90
|
|
|
MITOMYCIN 40 MG/20 ML BLADDER FOR IRRIGATION SOLUTION CUSTOM
|
Facility
|
IP
|
$5,615.87
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
301471
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,470.98 |
| Max. Negotiated Rate |
$5,054.28 |
| Rate for Payer: Aetna American Axle |
$3,650.32
|
| Rate for Payer: Aetna American Axle |
$602.76
|
| Rate for Payer: Aetna Commercial |
$4,773.49
|
| Rate for Payer: Aetna Commercial |
$788.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,650.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.76
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cofinity Advantage |
$649.12
|
| Rate for Payer: Cofinity Advantage |
$3,931.11
|
| Rate for Payer: Cofinity Commercial |
$797.50
|
| Rate for Payer: Cofinity Commercial |
$4,829.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.86
|
| Rate for Payer: Healthscope Commercial |
$5,054.28
|
| Rate for Payer: Healthscope Commercial |
$834.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,931.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,211.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,211.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$695.49
|
| Rate for Payer: PHP Commercial |
$4,773.49
|
| Rate for Payer: PHP Commercial |
$788.22
|
| Rate for Payer: Priority Health SBD |
$584.21
|
| Rate for Payer: Priority Health SBD |
$3,538.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,470.98
|
| Rate for Payer: UMR Bronson Commercial |
$408.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,211.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.49
|
|
|
MITOMYCIN 40 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$927.32
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$408.02 |
| Max. Negotiated Rate |
$834.59 |
| Rate for Payer: Aetna American Axle |
$602.76
|
| Rate for Payer: Aetna American Axle |
$581.85
|
| Rate for Payer: Aetna American Axle |
$617.91
|
| Rate for Payer: Aetna American Axle |
$3,650.32
|
| Rate for Payer: Aetna American Axle |
$3,430.64
|
| Rate for Payer: Aetna Commercial |
$4,486.22
|
| Rate for Payer: Aetna Commercial |
$760.88
|
| Rate for Payer: Aetna Commercial |
$788.22
|
| Rate for Payer: Aetna Commercial |
$808.04
|
| Rate for Payer: Aetna Commercial |
$4,773.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,650.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,430.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.91
|
| Rate for Payer: Cash Price |
$716.12
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cash Price |
$4,222.33
|
| Rate for Payer: Cofinity Advantage |
$3,694.54
|
| Rate for Payer: Cofinity Advantage |
$665.44
|
| Rate for Payer: Cofinity Advantage |
$3,931.11
|
| Rate for Payer: Cofinity Advantage |
$649.12
|
| Rate for Payer: Cofinity Advantage |
$626.61
|
| Rate for Payer: Cofinity Commercial |
$817.54
|
| Rate for Payer: Cofinity Commercial |
$4,539.00
|
| Rate for Payer: Cofinity Commercial |
$4,829.65
|
| Rate for Payer: Cofinity Commercial |
$769.83
|
| Rate for Payer: Cofinity Commercial |
$797.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.50
|
| Rate for Payer: Healthscope Commercial |
$4,750.12
|
| Rate for Payer: Healthscope Commercial |
$5,054.28
|
| Rate for Payer: Healthscope Commercial |
$805.63
|
| Rate for Payer: Healthscope Commercial |
$834.59
|
| Rate for Payer: Healthscope Commercial |
$855.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,931.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,694.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,958.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,211.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$760.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$808.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,958.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,211.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$695.49
|
| Rate for Payer: PHP Commercial |
$760.88
|
| Rate for Payer: PHP Commercial |
$4,486.22
|
| Rate for Payer: PHP Commercial |
$788.22
|
| Rate for Payer: PHP Commercial |
$808.04
|
| Rate for Payer: PHP Commercial |
$4,773.49
|
| Rate for Payer: Priority Health SBD |
$584.21
|
| Rate for Payer: Priority Health SBD |
$598.90
|
| Rate for Payer: Priority Health SBD |
$3,538.00
|
| Rate for Payer: Priority Health SBD |
$3,325.08
|
| Rate for Payer: Priority Health SBD |
$563.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,470.98
|
| Rate for Payer: UMR Bronson Commercial |
$418.28
|
| Rate for Payer: UMR Bronson Commercial |
$393.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,322.28
|
| Rate for Payer: UMR Bronson Commercial |
$408.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,958.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,211.90
|
|
|
MITOMYCIN 40 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$5,277.91
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10631
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$4,750.12 |
| Rate for Payer: Aetna American Axle |
$3,430.64
|
| Rate for Payer: Aetna American Axle |
$581.85
|
| Rate for Payer: Aetna American Axle |
$617.91
|
| Rate for Payer: Aetna American Axle |
$602.76
|
| Rate for Payer: Aetna American Axle |
$3,650.32
|
| Rate for Payer: Aetna Commercial |
$808.04
|
| Rate for Payer: Aetna Commercial |
$4,486.22
|
| Rate for Payer: Aetna Commercial |
$760.88
|
| Rate for Payer: Aetna Commercial |
$4,773.49
|
| Rate for Payer: Aetna Commercial |
$788.22
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,650.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,430.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$4,222.33
|
| Rate for Payer: Cash Price |
$4,222.33
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$741.86
|
| Rate for Payer: Cash Price |
$716.12
|
| Rate for Payer: Cash Price |
$716.12
|
| Rate for Payer: Cash Price |
$4,492.70
|
| Rate for Payer: Cofinity Advantage |
$3,694.54
|
| Rate for Payer: Cofinity Advantage |
$626.61
|
| Rate for Payer: Cofinity Advantage |
$665.44
|
| Rate for Payer: Cofinity Advantage |
$649.12
|
| Rate for Payer: Cofinity Advantage |
$3,931.11
|
| Rate for Payer: Cofinity Commercial |
$797.50
|
| Rate for Payer: Cofinity Commercial |
$4,539.00
|
| Rate for Payer: Cofinity Commercial |
$817.54
|
| Rate for Payer: Cofinity Commercial |
$769.83
|
| Rate for Payer: Cofinity Commercial |
$4,829.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$855.57
|
| Rate for Payer: Healthscope Commercial |
$4,750.12
|
| Rate for Payer: Healthscope Commercial |
$834.59
|
| Rate for Payer: Healthscope Commercial |
$805.63
|
| Rate for Payer: Healthscope Commercial |
$5,054.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,694.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,931.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,211.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,958.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.97
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$760.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$808.04
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,211.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$695.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,958.43
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$788.22
|
| Rate for Payer: PHP Commercial |
$760.88
|
| Rate for Payer: PHP Commercial |
$4,486.22
|
| Rate for Payer: PHP Commercial |
$4,773.49
|
| Rate for Payer: PHP Commercial |
$808.04
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health SBD |
$584.21
|
| Rate for Payer: Priority Health SBD |
$563.94
|
| Rate for Payer: Priority Health SBD |
$3,538.00
|
| Rate for Payer: Priority Health SBD |
$598.90
|
| Rate for Payer: Priority Health SBD |
$3,325.08
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$331.21
|
| Rate for Payer: UMR Bronson Commercial |
$351.73
|
| Rate for Payer: UMR Bronson Commercial |
$343.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,952.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,077.87
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,958.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,211.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.97
|
|
|
MITOMYCIN 5 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$541.04
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10632
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$486.94 |
| Rate for Payer: Aetna American Axle |
$351.68
|
| Rate for Payer: Aetna American Axle |
$320.35
|
| Rate for Payer: Aetna Commercial |
$418.91
|
| Rate for Payer: Aetna Commercial |
$459.88
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS Complete |
$15.63
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Commercial |
$84.63
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$394.27
|
| Rate for Payer: Cash Price |
$432.83
|
| Rate for Payer: Cash Price |
$432.83
|
| Rate for Payer: Cash Price |
$394.27
|
| Rate for Payer: Cofinity Advantage |
$378.73
|
| Rate for Payer: Cofinity Advantage |
$344.99
|
| Rate for Payer: Cofinity Commercial |
$423.84
|
| Rate for Payer: Cofinity Commercial |
$465.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$443.56
|
| Rate for Payer: Healthscope Commercial |
$486.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.78
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Mclaren Medicare |
$28.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$29.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.88
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Nomi Health Commercial |
$85.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.63
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE Medicare |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$418.91
|
| Rate for Payer: PHP Commercial |
$459.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.18
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health Medicare |
$28.46
|
| Rate for Payer: Priority Health SBD |
$310.49
|
| Rate for Payer: Priority Health SBD |
$340.86
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Priority Health Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Core |
$43.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.46
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Exchange |
$43.07
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHC Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UHCCP Medicaid |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$182.35
|
| Rate for Payer: UMR Bronson Commercial |
$200.18
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.63
|
|
|
MITOMYCIN 5 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$492.84
|
|
|
Service Code
|
HCPCS J9280
|
| Hospital Charge Code |
10632
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$216.85 |
| Max. Negotiated Rate |
$443.56 |
| Rate for Payer: Aetna American Axle |
$320.35
|
| Rate for Payer: Aetna American Axle |
$351.68
|
| Rate for Payer: Aetna Commercial |
$418.91
|
| Rate for Payer: Aetna Commercial |
$459.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.68
|
| Rate for Payer: Cash Price |
$394.27
|
| Rate for Payer: Cash Price |
$432.83
|
| Rate for Payer: Cofinity Advantage |
$378.73
|
| Rate for Payer: Cofinity Advantage |
$344.99
|
| Rate for Payer: Cofinity Commercial |
$465.29
|
| Rate for Payer: Cofinity Commercial |
$423.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.83
|
| Rate for Payer: Healthscope Commercial |
$443.56
|
| Rate for Payer: Healthscope Commercial |
$486.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.78
|
| Rate for Payer: PHP Commercial |
$418.91
|
| Rate for Payer: PHP Commercial |
$459.88
|
| Rate for Payer: Priority Health SBD |
$340.86
|
| Rate for Payer: Priority Health SBD |
$310.49
|
| Rate for Payer: UMR Bronson Commercial |
$216.85
|
| Rate for Payer: UMR Bronson Commercial |
$238.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.78
|
|
|
MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
IP
|
$802.15
|
|
|
Service Code
|
HCPCS J9293
|
| Hospital Charge Code |
10634
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$352.95 |
| Max. Negotiated Rate |
$721.93 |
| Rate for Payer: Aetna American Axle |
$521.40
|
| Rate for Payer: Aetna American Axle |
$729.26
|
| Rate for Payer: Aetna American Axle |
$543.71
|
| Rate for Payer: Aetna American Axle |
$651.79
|
| Rate for Payer: Aetna Commercial |
$711.01
|
| Rate for Payer: Aetna Commercial |
$681.83
|
| Rate for Payer: Aetna Commercial |
$852.34
|
| Rate for Payer: Aetna Commercial |
$953.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.79
|
| Rate for Payer: Cash Price |
$802.20
|
| Rate for Payer: Cash Price |
$669.18
|
| Rate for Payer: Cash Price |
$897.55
|
| Rate for Payer: Cash Price |
$641.72
|
| Rate for Payer: Cofinity Advantage |
$785.36
|
| Rate for Payer: Cofinity Advantage |
$701.92
|
| Rate for Payer: Cofinity Advantage |
$561.50
|
| Rate for Payer: Cofinity Advantage |
$585.54
|
| Rate for Payer: Cofinity Commercial |
$689.85
|
| Rate for Payer: Cofinity Commercial |
$862.37
|
| Rate for Payer: Cofinity Commercial |
$964.87
|
| Rate for Payer: Cofinity Commercial |
$719.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.55
|
| Rate for Payer: Healthscope Commercial |
$1,009.75
|
| Rate for Payer: Healthscope Commercial |
$752.83
|
| Rate for Payer: Healthscope Commercial |
$721.93
|
| Rate for Payer: Healthscope Commercial |
$902.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$561.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$701.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$585.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$852.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$627.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.06
|
| Rate for Payer: PHP Commercial |
$852.34
|
| Rate for Payer: PHP Commercial |
$681.83
|
| Rate for Payer: PHP Commercial |
$953.65
|
| Rate for Payer: PHP Commercial |
$711.01
|
| Rate for Payer: Priority Health SBD |
$526.98
|
| Rate for Payer: Priority Health SBD |
$631.73
|
| Rate for Payer: Priority Health SBD |
$505.35
|
| Rate for Payer: Priority Health SBD |
$706.82
|
| Rate for Payer: UMR Bronson Commercial |
$493.65
|
| Rate for Payer: UMR Bronson Commercial |
$352.95
|
| Rate for Payer: UMR Bronson Commercial |
$441.21
|
| Rate for Payer: UMR Bronson Commercial |
$368.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.36
|
|
|
MITOXANTRONE 2 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
OP
|
$1,121.94
|
|
|
Service Code
|
HCPCS J9293
|
| Hospital Charge Code |
10634
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$1,009.75 |
| Rate for Payer: Aetna American Axle |
$729.26
|
| Rate for Payer: Aetna American Axle |
$543.71
|
| Rate for Payer: Aetna American Axle |
$521.40
|
| Rate for Payer: Aetna American Axle |
$651.79
|
| Rate for Payer: Aetna Commercial |
$953.65
|
| Rate for Payer: Aetna Commercial |
$711.01
|
| Rate for Payer: Aetna Commercial |
$852.34
|
| Rate for Payer: Aetna Commercial |
$681.83
|
| Rate for Payer: Aetna Medicare |
$40.15
|
| Rate for Payer: Aetna Medicare |
$40.15
|
| Rate for Payer: Aetna Medicare |
$40.15
|
| Rate for Payer: Aetna Medicare |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.26
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$38.61
|
| Rate for Payer: BCBS MAPPO |
$38.61
|
| Rate for Payer: BCBS MAPPO |
$38.61
|
| Rate for Payer: BCBS MAPPO |
$38.61
|
| Rate for Payer: BCBS Trust/PPO |
$100.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.09
|
| Rate for Payer: BCN Commercial |
$100.09
|
| Rate for Payer: BCN Commercial |
$100.09
|
| Rate for Payer: BCN Commercial |
$100.09
|
| Rate for Payer: BCN Commercial |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$38.61
|
| Rate for Payer: BCN Medicare Advantage |
$38.61
|
| Rate for Payer: BCN Medicare Advantage |
$38.61
|
| Rate for Payer: BCN Medicare Advantage |
$38.61
|
| Rate for Payer: Cash Price |
$641.72
|
| Rate for Payer: Cash Price |
$897.55
|
| Rate for Payer: Cash Price |
$802.20
|
| Rate for Payer: Cash Price |
$669.18
|
| Rate for Payer: Cash Price |
$897.55
|
| Rate for Payer: Cash Price |
$641.72
|
| Rate for Payer: Cash Price |
$669.18
|
| Rate for Payer: Cash Price |
$802.20
|
| Rate for Payer: Cofinity Advantage |
$561.50
|
| Rate for Payer: Cofinity Advantage |
$701.92
|
| Rate for Payer: Cofinity Advantage |
$585.54
|
| Rate for Payer: Cofinity Advantage |
$785.36
|
| Rate for Payer: Cofinity Commercial |
$719.37
|
| Rate for Payer: Cofinity Commercial |
$964.87
|
| Rate for Payer: Cofinity Commercial |
$689.85
|
| Rate for Payer: Cofinity Commercial |
$862.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.61
|
| Rate for Payer: Healthscope Commercial |
$1,009.75
|
| Rate for Payer: Healthscope Commercial |
$721.93
|
| Rate for Payer: Healthscope Commercial |
$752.83
|
| Rate for Payer: Healthscope Commercial |
$902.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$585.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$701.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$561.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.06
|
| Rate for Payer: Mclaren Medicaid |
$38.61
|
| Rate for Payer: Mclaren Medicaid |
$38.61
|
| Rate for Payer: Mclaren Medicaid |
$38.61
|
| Rate for Payer: Mclaren Medicaid |
$38.61
|
| Rate for Payer: Mclaren Medicare |
$38.61
|
| Rate for Payer: Mclaren Medicare |
$38.61
|
| Rate for Payer: Mclaren Medicare |
$38.61
|
| Rate for Payer: Mclaren Medicare |
$38.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.54
|
| Rate for Payer: Meridian Medicaid |
$40.54
|
| Rate for Payer: Meridian Medicaid |
$40.54
|
| Rate for Payer: Meridian Medicaid |
$40.54
|
| Rate for Payer: Meridian Medicaid |
$40.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$852.34
|
| Rate for Payer: Nomi Health Commercial |
$115.83
|
| Rate for Payer: Nomi Health Commercial |
$115.83
|
| Rate for Payer: Nomi Health Commercial |
$115.83
|
| Rate for Payer: Nomi Health Commercial |
$115.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$627.36
|
| Rate for Payer: PACE Medicare |
$36.68
|
| Rate for Payer: PACE Medicare |
$36.68
|
| Rate for Payer: PACE Medicare |
$36.68
|
| Rate for Payer: PACE Medicare |
$36.68
|
| Rate for Payer: PACE SWMI |
$38.61
|
| Rate for Payer: PACE SWMI |
$38.61
|
| Rate for Payer: PACE SWMI |
$38.61
|
| Rate for Payer: PACE SWMI |
$38.61
|
| Rate for Payer: PHP Commercial |
$953.65
|
| Rate for Payer: PHP Commercial |
$711.01
|
| Rate for Payer: PHP Commercial |
$852.34
|
| Rate for Payer: PHP Commercial |
$681.83
|
| Rate for Payer: PHP Medicare Advantage |
$38.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.31
|
| Rate for Payer: Priority Health Medicare |
$38.61
|
| Rate for Payer: Priority Health Medicare |
$38.61
|
| Rate for Payer: Priority Health Medicare |
$38.61
|
| Rate for Payer: Priority Health Medicare |
$38.61
|
| Rate for Payer: Priority Health SBD |
$631.73
|
| Rate for Payer: Priority Health SBD |
$706.82
|
| Rate for Payer: Priority Health SBD |
$526.98
|
| Rate for Payer: Priority Health SBD |
$505.35
|
| Rate for Payer: Priority Health Tiered Network |
$60.25
|
| Rate for Payer: Priority Health Tiered Network |
$60.25
|
| Rate for Payer: Priority Health Tiered Network |
$60.25
|
| Rate for Payer: Priority Health Tiered Network |
$60.25
|
| Rate for Payer: Railroad Medicare Medicare |
$38.61
|
| Rate for Payer: Railroad Medicare Medicare |
$38.61
|
| Rate for Payer: Railroad Medicare Medicare |
$38.61
|
| Rate for Payer: Railroad Medicare Medicare |
$38.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.95
|
| Rate for Payer: UHC Core |
$50.95
|
| Rate for Payer: UHC Core |
$50.95
|
| Rate for Payer: UHC Core |
$50.95
|
| Rate for Payer: UHC Core |
$50.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.61
|
| Rate for Payer: UHC Exchange |
$50.95
|
| Rate for Payer: UHC Exchange |
$50.95
|
| Rate for Payer: UHC Exchange |
$50.95
|
| Rate for Payer: UHC Exchange |
$50.95
|
| Rate for Payer: UHC Medicaid |
$20.19
|
| Rate for Payer: UHC Medicaid |
$20.19
|
| Rate for Payer: UHC Medicaid |
$20.19
|
| Rate for Payer: UHC Medicaid |
$20.19
|
| Rate for Payer: UHCCP Medicaid |
$20.19
|
| Rate for Payer: UHCCP Medicaid |
$20.19
|
| Rate for Payer: UHCCP Medicaid |
$20.19
|
| Rate for Payer: UHCCP Medicaid |
$20.19
|
| Rate for Payer: UMR Bronson Commercial |
$296.80
|
| Rate for Payer: UMR Bronson Commercial |
$415.12
|
| Rate for Payer: UMR Bronson Commercial |
$371.02
|
| Rate for Payer: UMR Bronson Commercial |
$309.50
|
| Rate for Payer: VA VA |
$38.61
|
| Rate for Payer: VA VA |
$38.61
|
| Rate for Payer: VA VA |
$38.61
|
| Rate for Payer: VA VA |
$38.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.06
|
|
