|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$5.04
|
|
|
Service Code
|
NDC 68084047911
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$4.54 |
| Rate for Payer: Aetna American Axle |
$3.28
|
| Rate for Payer: Aetna Commercial |
$4.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.28
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cofinity Advantage |
$3.53
|
| Rate for Payer: Cofinity Commercial |
$4.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.03
|
| Rate for Payer: Healthscope Commercial |
$4.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.78
|
| Rate for Payer: PHP Commercial |
$4.28
|
| Rate for Payer: Priority Health SBD |
$3.18
|
| Rate for Payer: UMR Bronson Commercial |
$2.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.78
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$503.52
|
|
|
Service Code
|
NDC 68084047901
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$221.55 |
| Max. Negotiated Rate |
$453.17 |
| Rate for Payer: Aetna American Axle |
$327.29
|
| Rate for Payer: Aetna Commercial |
$427.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.29
|
| Rate for Payer: Cash Price |
$402.82
|
| Rate for Payer: Cofinity Advantage |
$352.46
|
| Rate for Payer: Cofinity Commercial |
$433.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.82
|
| Rate for Payer: Healthscope Commercial |
$453.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$352.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$377.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$377.64
|
| Rate for Payer: PHP Commercial |
$427.99
|
| Rate for Payer: Priority Health SBD |
$317.22
|
| Rate for Payer: UMR Bronson Commercial |
$221.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$377.64
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.70
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
108968
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$18.63 |
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna American Axle |
$21.87
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$28.60
|
| Rate for Payer: Aetna Medicare |
$10.35
|
| Rate for Payer: Aetna Medicare |
$16.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.87
|
| Rate for Payer: BCBS Complete |
$13.46
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cofinity Advantage |
$14.49
|
| Rate for Payer: Cofinity Advantage |
$23.55
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.92
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$28.60
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: Priority Health SBD |
$21.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.66
|
| Rate for Payer: UMR Bronson Commercial |
$12.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$33.65
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
108968
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.81 |
| Max. Negotiated Rate |
$30.29 |
| Rate for Payer: Aetna American Axle |
$21.87
|
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$28.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.87
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cofinity Advantage |
$23.55
|
| Rate for Payer: Cofinity Advantage |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.92
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.24
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$28.60
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: Priority Health SBD |
$21.20
|
| Rate for Payer: UMR Bronson Commercial |
$14.81
|
| Rate for Payer: UMR Bronson Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna American Axle |
$21.52
|
| Rate for Payer: Aetna American Axle |
$33.93
|
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna American Axle |
$23.55
|
| Rate for Payer: Aetna American Axle |
$45.85
|
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Medicare |
$35.27
|
| Rate for Payer: Aetna Medicare |
$18.11
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Aetna Medicare |
$19.67
|
| Rate for Payer: Aetna Medicare |
$26.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.85
|
| Rate for Payer: BCBS Complete |
$20.88
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Complete |
$14.49
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: BCBS Complete |
$28.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Advantage |
$36.54
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$27.54
|
| Rate for Payer: Cofinity Advantage |
$49.38
|
| Rate for Payer: Cofinity Advantage |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.91
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: Priority Health SBD |
$20.86
|
| Rate for Payer: Priority Health SBD |
$32.89
|
| Rate for Payer: Priority Health SBD |
$44.44
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$12.25
|
| Rate for Payer: UMR Bronson Commercial |
$19.31
|
| Rate for Payer: UMR Bronson Commercial |
$14.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.10
|
| Rate for Payer: UMR Bronson Commercial |
$13.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna American Axle |
$21.52
|
| Rate for Payer: Aetna American Axle |
$45.85
|
| Rate for Payer: Aetna American Axle |
$23.55
|
| Rate for Payer: Aetna American Axle |
$33.93
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.93
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Advantage |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$36.54
|
| Rate for Payer: Cofinity Advantage |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health SBD |
$20.86
|
| Rate for Payer: Priority Health SBD |
$32.89
|
| Rate for Payer: Priority Health SBD |
$44.44
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: UMR Bronson Commercial |
$15.94
|
| Rate for Payer: UMR Bronson Commercial |
$31.04
|
| Rate for Payer: UMR Bronson Commercial |
$22.97
|
| Rate for Payer: UMR Bronson Commercial |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
OP
|
$70.54
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna American Axle |
$45.85
|
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$35.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.85
|
| Rate for Payer: BCBS Complete |
$28.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Advantage |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.91
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health SBD |
$44.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$26.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.91
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
IP
|
$70.54
|
|
|
Service Code
|
HCPCS J0618
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna American Axle |
$45.85
|
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.85
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Advantage |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.91
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health SBD |
$44.44
|
| Rate for Payer: UMR Bronson Commercial |
$31.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.91
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$33.07
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$29.76 |
| Rate for Payer: Aetna American Axle |
$21.50
|
| Rate for Payer: Aetna American Axle |
$93.14
|
| Rate for Payer: Aetna American Axle |
$51.78
|
| Rate for Payer: Aetna Commercial |
$28.11
|
| Rate for Payer: Aetna Commercial |
$67.71
|
| Rate for Payer: Aetna Commercial |
$121.80
|
| Rate for Payer: Aetna Medicare |
$16.54
|
| Rate for Payer: Aetna Medicare |
$71.64
|
| Rate for Payer: Aetna Medicare |
$39.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.78
|
| Rate for Payer: BCBS Complete |
$57.32
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS Complete |
$31.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$114.63
|
| Rate for Payer: Cash Price |
$114.63
|
| Rate for Payer: Cash Price |
$63.73
|
| Rate for Payer: Cash Price |
$63.73
|
| Rate for Payer: Cash Price |
$26.46
|
| Rate for Payer: Cash Price |
$26.46
|
| Rate for Payer: Cofinity Advantage |
$55.76
|
| Rate for Payer: Cofinity Advantage |
$23.15
|
| Rate for Payer: Cofinity Advantage |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$123.23
|
| Rate for Payer: Cofinity Commercial |
$28.44
|
| Rate for Payer: Cofinity Commercial |
$68.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.46
|
| Rate for Payer: Healthscope Commercial |
$128.96
|
| Rate for Payer: Healthscope Commercial |
$29.76
|
| Rate for Payer: Healthscope Commercial |
$71.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.74
|
| Rate for Payer: PHP Commercial |
$28.11
|
| Rate for Payer: PHP Commercial |
$121.80
|
| Rate for Payer: PHP Commercial |
$67.71
|
| Rate for Payer: Priority Health SBD |
$90.27
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: Priority Health SBD |
$20.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$29.47
|
| Rate for Payer: UMR Bronson Commercial |
$53.02
|
| Rate for Payer: UMR Bronson Commercial |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.74
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$143.29
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$63.05 |
| Max. Negotiated Rate |
$128.96 |
| Rate for Payer: Aetna American Axle |
$93.14
|
| Rate for Payer: Aetna American Axle |
$51.78
|
| Rate for Payer: Aetna American Axle |
$21.50
|
| Rate for Payer: Aetna Commercial |
$28.11
|
| Rate for Payer: Aetna Commercial |
$121.80
|
| Rate for Payer: Aetna Commercial |
$67.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.50
|
| Rate for Payer: Cash Price |
$26.46
|
| Rate for Payer: Cash Price |
$114.63
|
| Rate for Payer: Cash Price |
$63.73
|
| Rate for Payer: Cofinity Advantage |
$55.76
|
| Rate for Payer: Cofinity Advantage |
$100.30
|
| Rate for Payer: Cofinity Advantage |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$68.51
|
| Rate for Payer: Cofinity Commercial |
$123.23
|
| Rate for Payer: Cofinity Commercial |
$28.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$29.76
|
| Rate for Payer: Healthscope Commercial |
$71.69
|
| Rate for Payer: Healthscope Commercial |
$128.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.74
|
| Rate for Payer: PHP Commercial |
$28.11
|
| Rate for Payer: PHP Commercial |
$121.80
|
| Rate for Payer: PHP Commercial |
$67.71
|
| Rate for Payer: Priority Health SBD |
$90.27
|
| Rate for Payer: Priority Health SBD |
$20.83
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: UMR Bronson Commercial |
$63.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.74
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$112.59
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$101.33 |
| Rate for Payer: Aetna American Axle |
$73.18
|
| Rate for Payer: Aetna American Axle |
$18.28
|
| Rate for Payer: Aetna American Axle |
$27.54
|
| Rate for Payer: Aetna American Axle |
$74.05
|
| Rate for Payer: Aetna American Axle |
$74.34
|
| Rate for Payer: Aetna Commercial |
$96.83
|
| Rate for Payer: Aetna Commercial |
$97.21
|
| Rate for Payer: Aetna Commercial |
$95.70
|
| Rate for Payer: Aetna Commercial |
$36.01
|
| Rate for Payer: Aetna Commercial |
$23.91
|
| Rate for Payer: Aetna Medicare |
$21.18
|
| Rate for Payer: Aetna Medicare |
$57.19
|
| Rate for Payer: Aetna Medicare |
$56.30
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna Medicare |
$56.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.18
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS Complete |
$45.57
|
| Rate for Payer: BCBS Complete |
$45.75
|
| Rate for Payer: BCBS Complete |
$11.25
|
| Rate for Payer: BCBS Complete |
$45.04
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$90.07
|
| Rate for Payer: Cash Price |
$91.14
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cash Price |
$33.90
|
| Rate for Payer: Cofinity Advantage |
$29.66
|
| Rate for Payer: Cofinity Advantage |
$19.69
|
| Rate for Payer: Cofinity Advantage |
$79.74
|
| Rate for Payer: Cofinity Advantage |
$78.81
|
| Rate for Payer: Cofinity Advantage |
$80.06
|
| Rate for Payer: Cofinity Commercial |
$36.44
|
| Rate for Payer: Cofinity Commercial |
$97.97
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Cofinity Commercial |
$98.36
|
| Rate for Payer: Cofinity Commercial |
$96.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.07
|
| Rate for Payer: Healthscope Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$38.13
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Healthscope Commercial |
$102.93
|
| Rate for Payer: Healthscope Commercial |
$25.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.78
|
| Rate for Payer: PHP Commercial |
$97.21
|
| Rate for Payer: PHP Commercial |
$36.01
|
| Rate for Payer: PHP Commercial |
$23.91
|
| Rate for Payer: PHP Commercial |
$95.70
|
| Rate for Payer: PHP Commercial |
$96.83
|
| Rate for Payer: Priority Health SBD |
$71.77
|
| Rate for Payer: Priority Health SBD |
$70.93
|
| Rate for Payer: Priority Health SBD |
$72.05
|
| Rate for Payer: Priority Health SBD |
$17.72
|
| Rate for Payer: Priority Health SBD |
$26.69
|
| Rate for Payer: UMR Bronson Commercial |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.41
|
| Rate for Payer: UMR Bronson Commercial |
$42.15
|
| Rate for Payer: UMR Bronson Commercial |
$41.66
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.78
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.13
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.38 |
| Max. Negotiated Rate |
$25.32 |
| Rate for Payer: Aetna American Axle |
$18.28
|
| Rate for Payer: Aetna American Axle |
$74.34
|
| Rate for Payer: Aetna American Axle |
$27.54
|
| Rate for Payer: Aetna American Axle |
$74.05
|
| Rate for Payer: Aetna American Axle |
$73.18
|
| Rate for Payer: Aetna Commercial |
$95.70
|
| Rate for Payer: Aetna Commercial |
$97.21
|
| Rate for Payer: Aetna Commercial |
$23.91
|
| Rate for Payer: Aetna Commercial |
$36.01
|
| Rate for Payer: Aetna Commercial |
$96.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.54
|
| Rate for Payer: Cash Price |
$91.50
|
| Rate for Payer: Cash Price |
$91.14
|
| Rate for Payer: Cash Price |
$33.90
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$90.07
|
| Rate for Payer: Cofinity Advantage |
$78.81
|
| Rate for Payer: Cofinity Advantage |
$29.66
|
| Rate for Payer: Cofinity Advantage |
$79.74
|
| Rate for Payer: Cofinity Advantage |
$19.69
|
| Rate for Payer: Cofinity Advantage |
$80.06
|
| Rate for Payer: Cofinity Commercial |
$36.44
|
| Rate for Payer: Cofinity Commercial |
$96.83
|
| Rate for Payer: Cofinity Commercial |
$97.97
|
| Rate for Payer: Cofinity Commercial |
$98.36
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.90
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Healthscope Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$102.93
|
| Rate for Payer: Healthscope Commercial |
$25.32
|
| Rate for Payer: Healthscope Commercial |
$38.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.10
|
| Rate for Payer: PHP Commercial |
$97.21
|
| Rate for Payer: PHP Commercial |
$95.70
|
| Rate for Payer: PHP Commercial |
$23.91
|
| Rate for Payer: PHP Commercial |
$36.01
|
| Rate for Payer: PHP Commercial |
$96.83
|
| Rate for Payer: Priority Health SBD |
$17.72
|
| Rate for Payer: Priority Health SBD |
$26.69
|
| Rate for Payer: Priority Health SBD |
$71.77
|
| Rate for Payer: Priority Health SBD |
$70.93
|
| Rate for Payer: Priority Health SBD |
$72.05
|
| Rate for Payer: UMR Bronson Commercial |
$50.12
|
| Rate for Payer: UMR Bronson Commercial |
$18.64
|
| Rate for Payer: UMR Bronson Commercial |
$50.32
|
| Rate for Payer: UMR Bronson Commercial |
$49.54
|
| Rate for Payer: UMR Bronson Commercial |
$12.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.44
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS (TPN COMPONENT)
|
Facility
|
IP
|
$167.77
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
180903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.82 |
| Max. Negotiated Rate |
$150.99 |
| Rate for Payer: Aetna American Axle |
$109.05
|
| Rate for Payer: Aetna Commercial |
$142.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.05
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Advantage |
$117.44
|
| Rate for Payer: Cofinity Commercial |
$144.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Healthscope Commercial |
$150.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.83
|
| Rate for Payer: PHP Commercial |
$142.60
|
| Rate for Payer: Priority Health SBD |
$105.70
|
| Rate for Payer: UMR Bronson Commercial |
$73.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.83
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS (TPN COMPONENT)
|
Facility
|
OP
|
$167.77
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
180903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$150.99 |
| Rate for Payer: Aetna American Axle |
$109.05
|
| Rate for Payer: Aetna Commercial |
$142.60
|
| Rate for Payer: Aetna Medicare |
$83.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.05
|
| Rate for Payer: BCBS Complete |
$67.11
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Advantage |
$117.44
|
| Rate for Payer: Cofinity Commercial |
$144.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Healthscope Commercial |
$150.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.83
|
| Rate for Payer: PHP Commercial |
$142.60
|
| Rate for Payer: Priority Health SBD |
$105.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$62.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.83
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
OP
|
$35.38
|
|
|
Service Code
|
HCPCS J0613
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$31.84 |
| Rate for Payer: Aetna American Axle |
$23.00
|
| Rate for Payer: Aetna Commercial |
$30.07
|
| Rate for Payer: Aetna Medicare |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PHP Commercial |
$30.07
|
| Rate for Payer: Priority Health SBD |
$22.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
IP
|
$35.38
|
|
|
Service Code
|
HCPCS J0613
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$31.84 |
| Rate for Payer: Aetna American Axle |
$23.00
|
| Rate for Payer: Aetna Commercial |
$30.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PHP Commercial |
$30.07
|
| Rate for Payer: Priority Health SBD |
$22.29
|
| Rate for Payer: UMR Bronson Commercial |
$15.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
IP
|
$34.05
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna American Axle |
$22.13
|
| Rate for Payer: Aetna American Axle |
$22.71
|
| Rate for Payer: Aetna Commercial |
$28.94
|
| Rate for Payer: Aetna Commercial |
$29.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.71
|
| Rate for Payer: Cash Price |
$27.24
|
| Rate for Payer: Cash Price |
$27.95
|
| Rate for Payer: Cofinity Advantage |
$24.46
|
| Rate for Payer: Cofinity Advantage |
$23.84
|
| Rate for Payer: Cofinity Commercial |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.95
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.20
|
| Rate for Payer: PHP Commercial |
$28.94
|
| Rate for Payer: PHP Commercial |
$29.70
|
| Rate for Payer: Priority Health SBD |
$22.01
|
| Rate for Payer: Priority Health SBD |
$21.45
|
| Rate for Payer: UMR Bronson Commercial |
$14.98
|
| Rate for Payer: UMR Bronson Commercial |
$15.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.20
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
OP
|
$34.05
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna American Axle |
$22.13
|
| Rate for Payer: Aetna American Axle |
$22.71
|
| Rate for Payer: Aetna Commercial |
$28.94
|
| Rate for Payer: Aetna Commercial |
$29.70
|
| Rate for Payer: Aetna Medicare |
$17.02
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.71
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS Complete |
$13.62
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$27.24
|
| Rate for Payer: Cash Price |
$27.95
|
| Rate for Payer: Cash Price |
$27.24
|
| Rate for Payer: Cash Price |
$27.95
|
| Rate for Payer: Cofinity Advantage |
$23.84
|
| Rate for Payer: Cofinity Advantage |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Cofinity Commercial |
$30.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.95
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.54
|
| Rate for Payer: PHP Commercial |
$28.94
|
| Rate for Payer: PHP Commercial |
$29.70
|
| Rate for Payer: Priority Health SBD |
$21.45
|
| Rate for Payer: Priority Health SBD |
$22.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.20
|
|
|
CALCIUM GLUCONATE 2.5 % GEL 25 GM
|
Facility
|
IP
|
$67.78
|
|
|
Service Code
|
NDC 09900001931
|
| Hospital Charge Code |
301456
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$61.00 |
| Rate for Payer: Aetna American Axle |
$44.06
|
| Rate for Payer: Aetna Commercial |
$57.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: Cash Price |
$54.22
|
| Rate for Payer: Cofinity Advantage |
$47.45
|
| Rate for Payer: Cofinity Commercial |
$58.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.22
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.84
|
| Rate for Payer: PHP Commercial |
$57.61
|
| Rate for Payer: Priority Health SBD |
$42.70
|
| Rate for Payer: UMR Bronson Commercial |
$29.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
|
CALCIUM GLUCONATE 2.5 % GEL 25 GM
|
Facility
|
OP
|
$67.78
|
|
|
Service Code
|
NDC 09900001931
|
| Hospital Charge Code |
301456
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.08 |
| Max. Negotiated Rate |
$61.00 |
| Rate for Payer: Aetna American Axle |
$44.06
|
| Rate for Payer: Aetna Commercial |
$57.61
|
| Rate for Payer: Aetna Medicare |
$33.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: BCBS Complete |
$27.11
|
| Rate for Payer: Cash Price |
$54.22
|
| Rate for Payer: Cofinity Advantage |
$47.45
|
| Rate for Payer: Cofinity Commercial |
$58.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.22
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.84
|
| Rate for Payer: PHP Commercial |
$57.61
|
| Rate for Payer: Priority Health SBD |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.06
|
| Rate for Payer: UHC Core |
$35.31
|
| Rate for Payer: UHC Exchange |
$26.64
|
| Rate for Payer: UMR Bronson Commercial |
$25.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
|
CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION
|
Facility
|
IP
|
$71.20
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
190608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.33 |
| Max. Negotiated Rate |
$64.08 |
| Rate for Payer: Aetna American Axle |
$46.28
|
| Rate for Payer: Aetna American Axle |
$49.17
|
| Rate for Payer: Aetna Commercial |
$60.52
|
| Rate for Payer: Aetna Commercial |
$64.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.17
|
| Rate for Payer: Cash Price |
$56.96
|
| Rate for Payer: Cash Price |
$60.52
|
| Rate for Payer: Cofinity Advantage |
$52.95
|
| Rate for Payer: Cofinity Advantage |
$49.84
|
| Rate for Payer: Cofinity Commercial |
$65.06
|
| Rate for Payer: Cofinity Commercial |
$61.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.52
|
| Rate for Payer: Healthscope Commercial |
$64.08
|
| Rate for Payer: Healthscope Commercial |
$68.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.74
|
| Rate for Payer: PHP Commercial |
$60.52
|
| Rate for Payer: PHP Commercial |
$64.30
|
| Rate for Payer: Priority Health SBD |
$47.66
|
| Rate for Payer: Priority Health SBD |
$44.86
|
| Rate for Payer: UMR Bronson Commercial |
$31.33
|
| Rate for Payer: UMR Bronson Commercial |
$33.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.74
|
|
|
CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION
|
Facility
|
OP
|
$74.32
|
|
|
Service Code
|
HCPCS J0613
|
| Hospital Charge Code |
190608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$66.89 |
| Rate for Payer: Aetna American Axle |
$48.31
|
| Rate for Payer: Aetna Commercial |
$63.17
|
| Rate for Payer: Aetna Medicare |
$37.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.31
|
| Rate for Payer: BCBS Complete |
$29.73
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$59.46
|
| Rate for Payer: Cash Price |
$59.46
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.46
|
| Rate for Payer: Healthscope Commercial |
$66.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.74
|
| Rate for Payer: PHP Commercial |
$63.17
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UMR Bronson Commercial |
$27.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.74
|
|
|
CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION
|
Facility
|
IP
|
$74.32
|
|
|
Service Code
|
HCPCS J0613
|
| Hospital Charge Code |
190608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.70 |
| Max. Negotiated Rate |
$66.89 |
| Rate for Payer: Aetna American Axle |
$48.31
|
| Rate for Payer: Aetna Commercial |
$63.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.31
|
| Rate for Payer: Cash Price |
$59.46
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.46
|
| Rate for Payer: Healthscope Commercial |
$66.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.74
|
| Rate for Payer: PHP Commercial |
$63.17
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UMR Bronson Commercial |
$32.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.74
|
|
|
CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION
|
Facility
|
OP
|
$71.20
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
190608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$64.08 |
| Rate for Payer: Aetna American Axle |
$46.28
|
| Rate for Payer: Aetna American Axle |
$49.17
|
| Rate for Payer: Aetna Commercial |
$60.52
|
| Rate for Payer: Aetna Commercial |
$64.30
|
| Rate for Payer: Aetna Medicare |
$35.60
|
| Rate for Payer: Aetna Medicare |
$37.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.17
|
| Rate for Payer: BCBS Complete |
$30.26
|
| Rate for Payer: BCBS Complete |
$28.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$56.96
|
| Rate for Payer: Cash Price |
$60.52
|
| Rate for Payer: Cash Price |
$56.96
|
| Rate for Payer: Cash Price |
$60.52
|
| Rate for Payer: Cofinity Advantage |
$49.84
|
| Rate for Payer: Cofinity Advantage |
$52.95
|
| Rate for Payer: Cofinity Commercial |
$61.23
|
| Rate for Payer: Cofinity Commercial |
$65.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.52
|
| Rate for Payer: Healthscope Commercial |
$64.08
|
| Rate for Payer: Healthscope Commercial |
$68.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.40
|
| Rate for Payer: PHP Commercial |
$60.52
|
| Rate for Payer: PHP Commercial |
$64.30
|
| Rate for Payer: Priority Health SBD |
$44.86
|
| Rate for Payer: Priority Health SBD |
$47.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$26.34
|
| Rate for Payer: UMR Bronson Commercial |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.74
|
|
|
CALCIUM GLUCONATE (BULK) POWDER
|
Facility
|
OP
|
$366.00
|
|
|
Service Code
|
NDC 38779182608
|
| Hospital Charge Code |
1316
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.42 |
| Max. Negotiated Rate |
$329.40 |
| Rate for Payer: Aetna American Axle |
$237.90
|
| Rate for Payer: Aetna Commercial |
$311.10
|
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.90
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Advantage |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$314.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.80
|
| Rate for Payer: Healthscope Commercial |
$329.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: PHP Commercial |
$311.10
|
| Rate for Payer: Priority Health SBD |
$230.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.90
|
| Rate for Payer: UHC Core |
$190.69
|
| Rate for Payer: UHC Exchange |
$143.84
|
| Rate for Payer: UMR Bronson Commercial |
$135.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.50
|
|
