|
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY;
|
Facility
|
OP
|
$12,013.78
|
|
|
Service Code
|
CPT 31256
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,942.91 |
| Max. Negotiated Rate |
$12,013.78 |
| Rate for Payer: Aetna Medicare |
$3,863.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,643.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,643.68
|
| Rate for Payer: BCBS Complete |
$2,040.25
|
| Rate for Payer: BCBS MAPPO |
$3,714.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,453.66
|
| Rate for Payer: BCN Commercial |
$2,453.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,714.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,714.94
|
| Rate for Payer: Mclaren Medicaid |
$3,714.94
|
| Rate for Payer: Mclaren Medicare |
$3,714.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,900.69
|
| Rate for Payer: Meridian Medicaid |
$3,900.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,272.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,086.43
|
| Rate for Payer: Nomi Health Commercial |
$11,144.82
|
| Rate for Payer: PACE Medicare |
$3,529.19
|
| Rate for Payer: PACE SWMI |
$3,714.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,714.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,013.78
|
| Rate for Payer: Priority Health Medicare |
$3,714.94
|
| Rate for Payer: Priority Health Tiered Network |
$9,611.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,714.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,714.94
|
| Rate for Payer: UHC Medicaid |
$1,942.91
|
| Rate for Payer: UHCCP Medicaid |
$1,942.91
|
| Rate for Payer: VA VA |
$3,714.94
|
|
|
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SINUS
|
Facility
|
OP
|
$22,741.12
|
|
|
Service Code
|
CPT 31267
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,677.78 |
| Max. Negotiated Rate |
$22,741.12 |
| Rate for Payer: Aetna Medicare |
$7,313.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,790.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,790.10
|
| Rate for Payer: BCBS Complete |
$3,862.02
|
| Rate for Payer: BCBS MAPPO |
$7,032.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,078.77
|
| Rate for Payer: BCN Commercial |
$5,078.77
|
| Rate for Payer: BCN Medicare Advantage |
$7,032.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,032.08
|
| Rate for Payer: Mclaren Medicaid |
$7,032.08
|
| Rate for Payer: Mclaren Medicare |
$7,032.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,383.68
|
| Rate for Payer: Meridian Medicaid |
$7,383.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,086.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,735.29
|
| Rate for Payer: Nomi Health Commercial |
$21,096.24
|
| Rate for Payer: PACE Medicare |
$6,680.48
|
| Rate for Payer: PACE SWMI |
$7,032.08
|
| Rate for Payer: PHP Medicare Advantage |
$7,032.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,677.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,741.12
|
| Rate for Payer: Priority Health Medicare |
$7,032.08
|
| Rate for Payer: Priority Health Tiered Network |
$18,192.90
|
| Rate for Payer: Railroad Medicare Medicare |
$7,032.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,032.08
|
| Rate for Payer: UHC Medicaid |
$3,677.78
|
| Rate for Payer: UHCCP Medicaid |
$3,677.78
|
| Rate for Payer: VA VA |
$7,032.08
|
|
|
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY;
|
Facility
|
OP
|
$22,741.12
|
|
|
Service Code
|
CPT 31287
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,217.16 |
| Max. Negotiated Rate |
$22,741.12 |
| Rate for Payer: Aetna Medicare |
$7,313.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,790.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,790.10
|
| Rate for Payer: BCBS Complete |
$3,862.02
|
| Rate for Payer: BCBS MAPPO |
$7,032.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,217.16
|
| Rate for Payer: BCN Commercial |
$3,217.16
|
| Rate for Payer: BCN Medicare Advantage |
$7,032.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,032.08
|
| Rate for Payer: Mclaren Medicaid |
$7,032.08
|
| Rate for Payer: Mclaren Medicare |
$7,032.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,383.68
|
| Rate for Payer: Meridian Medicaid |
$7,383.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,086.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,735.29
|
| Rate for Payer: Nomi Health Commercial |
$21,096.24
|
| Rate for Payer: PACE Medicare |
$6,680.48
|
| Rate for Payer: PACE SWMI |
$7,032.08
|
| Rate for Payer: PHP Medicare Advantage |
$7,032.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,677.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,741.12
|
| Rate for Payer: Priority Health Medicare |
$7,032.08
|
| Rate for Payer: Priority Health Tiered Network |
$18,192.90
|
| Rate for Payer: Railroad Medicare Medicare |
$7,032.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,032.08
|
| Rate for Payer: UHC Medicaid |
$3,677.78
|
| Rate for Payer: UHCCP Medicaid |
$3,677.78
|
| Rate for Payer: VA VA |
$7,032.08
|
|
|
NASOPHARYNGOSCOPY, SURGICAL, WITH DILATION OF EUSTACHIAN TUBE (IE, BALLOON DILATION); BILATERAL
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 69706
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,385.62
|
| Rate for Payer: BCN Commercial |
$5,385.62
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
NASOPHARYNGOSCOPY, SURGICAL, WITH DILATION OF EUSTACHIAN TUBE (IE, BALLOON DILATION); UNILATERAL
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 69705
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$4,995.40
|
| Rate for Payer: BCN Commercial |
$4,995.40
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23,085.98
|
|
|
Service Code
|
HCPCS J2323
|
| Hospital Charge Code |
40120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10,157.83 |
| Max. Negotiated Rate |
$20,777.38 |
| Rate for Payer: Aetna American Axle |
$15,005.89
|
| Rate for Payer: Aetna Commercial |
$19,623.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,005.89
|
| Rate for Payer: Cash Price |
$18,468.78
|
| Rate for Payer: Cofinity Advantage |
$16,160.19
|
| Rate for Payer: Cofinity Commercial |
$19,853.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,468.78
|
| Rate for Payer: Healthscope Commercial |
$20,777.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,160.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,314.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,623.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17,314.49
|
| Rate for Payer: PHP Commercial |
$19,623.08
|
| Rate for Payer: Priority Health SBD |
$14,544.17
|
| Rate for Payer: UMR Bronson Commercial |
$10,157.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,314.49
|
|
|
NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23,085.98
|
|
|
Service Code
|
HCPCS J2323
|
| Hospital Charge Code |
40120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$20,777.38 |
| Rate for Payer: Aetna American Axle |
$15,005.89
|
| Rate for Payer: Aetna Commercial |
$19,623.08
|
| Rate for Payer: Aetna Medicare |
$25.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,005.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.40
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$24.32
|
| Rate for Payer: BCBS Trust/PPO |
$79.47
|
| Rate for Payer: BCN Commercial |
$79.47
|
| Rate for Payer: BCN Medicare Advantage |
$24.32
|
| Rate for Payer: Cash Price |
$18,468.78
|
| Rate for Payer: Cash Price |
$18,468.78
|
| Rate for Payer: Cofinity Advantage |
$16,160.19
|
| Rate for Payer: Cofinity Commercial |
$19,853.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,468.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$20,777.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,160.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,314.49
|
| Rate for Payer: Mclaren Medicaid |
$24.32
|
| Rate for Payer: Mclaren Medicare |
$24.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.54
|
| Rate for Payer: Meridian Medicaid |
$25.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,623.08
|
| Rate for Payer: Nomi Health Commercial |
$72.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17,314.49
|
| Rate for Payer: PACE Medicare |
$23.10
|
| Rate for Payer: PACE SWMI |
$24.32
|
| Rate for Payer: PHP Commercial |
$19,623.08
|
| Rate for Payer: PHP Medicare Advantage |
$24.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.68
|
| Rate for Payer: Priority Health Medicare |
$24.32
|
| Rate for Payer: Priority Health SBD |
$14,544.17
|
| Rate for Payer: Priority Health Tiered Network |
$60.54
|
| Rate for Payer: Railroad Medicare Medicare |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.44
|
| Rate for Payer: UHC Core |
$40.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.32
|
| Rate for Payer: UHC Exchange |
$40.44
|
| Rate for Payer: UHC Medicaid |
$12.72
|
| Rate for Payer: UHCCP Medicaid |
$12.72
|
| Rate for Payer: UMR Bronson Commercial |
$8,541.81
|
| Rate for Payer: VA VA |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,314.49
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
OP
|
$530.88
|
|
|
Service Code
|
NDC 49884098401
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.43 |
| Max. Negotiated Rate |
$477.79 |
| Rate for Payer: Aetna American Axle |
$345.07
|
| Rate for Payer: Aetna Commercial |
$451.25
|
| Rate for Payer: Aetna Medicare |
$265.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.07
|
| Rate for Payer: BCBS Complete |
$212.35
|
| Rate for Payer: Cash Price |
$424.70
|
| Rate for Payer: Cofinity Advantage |
$371.62
|
| Rate for Payer: Cofinity Commercial |
$456.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.70
|
| Rate for Payer: Healthscope Commercial |
$477.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$398.16
|
| Rate for Payer: PHP Commercial |
$451.25
|
| Rate for Payer: Priority Health SBD |
$334.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.07
|
| Rate for Payer: UHC Core |
$276.59
|
| Rate for Payer: UHC Exchange |
$208.64
|
| Rate for Payer: UMR Bronson Commercial |
$196.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.16
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
IP
|
$364.23
|
|
|
Service Code
|
NDC 55111032890
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$160.26 |
| Max. Negotiated Rate |
$327.81 |
| Rate for Payer: Aetna American Axle |
$236.75
|
| Rate for Payer: Aetna Commercial |
$309.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.75
|
| Rate for Payer: Cash Price |
$291.38
|
| Rate for Payer: Cofinity Advantage |
$254.96
|
| Rate for Payer: Cofinity Commercial |
$313.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.38
|
| Rate for Payer: Healthscope Commercial |
$327.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.17
|
| Rate for Payer: PHP Commercial |
$309.60
|
| Rate for Payer: Priority Health SBD |
$229.46
|
| Rate for Payer: UMR Bronson Commercial |
$160.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.17
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
IP
|
$413.25
|
|
|
Service Code
|
NDC 75834020501
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$181.83 |
| Max. Negotiated Rate |
$371.93 |
| Rate for Payer: Aetna American Axle |
$268.61
|
| Rate for Payer: Aetna Commercial |
$351.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.61
|
| Rate for Payer: Cash Price |
$330.60
|
| Rate for Payer: Cofinity Advantage |
$289.27
|
| Rate for Payer: Cofinity Commercial |
$355.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.60
|
| Rate for Payer: Healthscope Commercial |
$371.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.94
|
| Rate for Payer: PHP Commercial |
$351.26
|
| Rate for Payer: Priority Health SBD |
$260.35
|
| Rate for Payer: UMR Bronson Commercial |
$181.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.94
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
IP
|
$249.66
|
|
|
Service Code
|
NDC 16571075809
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.85 |
| Max. Negotiated Rate |
$224.69 |
| Rate for Payer: Aetna American Axle |
$162.28
|
| Rate for Payer: Aetna Commercial |
$212.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.28
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Cofinity Advantage |
$174.76
|
| Rate for Payer: Cofinity Commercial |
$214.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.73
|
| Rate for Payer: Healthscope Commercial |
$224.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.25
|
| Rate for Payer: PHP Commercial |
$212.21
|
| Rate for Payer: Priority Health SBD |
$157.29
|
| Rate for Payer: UMR Bronson Commercial |
$109.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.25
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
IP
|
$530.88
|
|
|
Service Code
|
NDC 49884098401
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$233.59 |
| Max. Negotiated Rate |
$477.79 |
| Rate for Payer: Aetna American Axle |
$345.07
|
| Rate for Payer: Aetna Commercial |
$451.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.07
|
| Rate for Payer: Cash Price |
$424.70
|
| Rate for Payer: Cofinity Advantage |
$371.62
|
| Rate for Payer: Cofinity Commercial |
$456.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.70
|
| Rate for Payer: Healthscope Commercial |
$477.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$398.16
|
| Rate for Payer: PHP Commercial |
$451.25
|
| Rate for Payer: Priority Health SBD |
$334.45
|
| Rate for Payer: UMR Bronson Commercial |
$233.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.16
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
OP
|
$413.25
|
|
|
Service Code
|
NDC 75834020501
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.90 |
| Max. Negotiated Rate |
$371.93 |
| Rate for Payer: Aetna American Axle |
$268.61
|
| Rate for Payer: Aetna Commercial |
$351.26
|
| Rate for Payer: Aetna Medicare |
$206.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.61
|
| Rate for Payer: BCBS Complete |
$165.30
|
| Rate for Payer: Cash Price |
$330.60
|
| Rate for Payer: Cofinity Advantage |
$289.27
|
| Rate for Payer: Cofinity Commercial |
$355.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.60
|
| Rate for Payer: Healthscope Commercial |
$371.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$330.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.94
|
| Rate for Payer: PHP Commercial |
$351.26
|
| Rate for Payer: Priority Health SBD |
$260.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.61
|
| Rate for Payer: UHC Core |
$215.30
|
| Rate for Payer: UHC Exchange |
$162.41
|
| Rate for Payer: UMR Bronson Commercial |
$152.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.94
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
OP
|
$364.23
|
|
|
Service Code
|
NDC 55111032890
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.77 |
| Max. Negotiated Rate |
$327.81 |
| Rate for Payer: Aetna American Axle |
$236.75
|
| Rate for Payer: Aetna Commercial |
$309.60
|
| Rate for Payer: Aetna Medicare |
$182.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.75
|
| Rate for Payer: BCBS Complete |
$145.69
|
| Rate for Payer: Cash Price |
$291.38
|
| Rate for Payer: Cofinity Advantage |
$254.96
|
| Rate for Payer: Cofinity Commercial |
$313.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.38
|
| Rate for Payer: Healthscope Commercial |
$327.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.17
|
| Rate for Payer: PHP Commercial |
$309.60
|
| Rate for Payer: Priority Health SBD |
$229.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.75
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: UHC Exchange |
$143.14
|
| Rate for Payer: UMR Bronson Commercial |
$134.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.17
|
|
|
NATEGLINIDE 60 MG TABLET
|
Facility
|
OP
|
$249.66
|
|
|
Service Code
|
NDC 16571075809
|
| Hospital Charge Code |
29437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.37 |
| Max. Negotiated Rate |
$224.69 |
| Rate for Payer: Aetna American Axle |
$162.28
|
| Rate for Payer: Aetna Commercial |
$212.21
|
| Rate for Payer: Aetna Medicare |
$124.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.28
|
| Rate for Payer: BCBS Complete |
$99.86
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Cofinity Advantage |
$174.76
|
| Rate for Payer: Cofinity Commercial |
$214.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.73
|
| Rate for Payer: Healthscope Commercial |
$224.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.25
|
| Rate for Payer: PHP Commercial |
$212.21
|
| Rate for Payer: Priority Health SBD |
$157.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.28
|
| Rate for Payer: UHC Core |
$130.07
|
| Rate for Payer: UHC Exchange |
$98.12
|
| Rate for Payer: UMR Bronson Commercial |
$92.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.25
|
|
|
NECITUMUMAB 800 MG/50 ML (16 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19,440.58
|
|
|
Service Code
|
HCPCS J9295
|
| Hospital Charge Code |
176602
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$17,496.52 |
| Rate for Payer: Aetna American Axle |
$12,636.38
|
| Rate for Payer: Aetna Commercial |
$16,524.49
|
| Rate for Payer: Aetna Medicare |
$5.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,636.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.16
|
| Rate for Payer: BCBS Complete |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$5.73
|
| Rate for Payer: BCBS Trust/PPO |
$18.55
|
| Rate for Payer: BCN Commercial |
$18.55
|
| Rate for Payer: BCN Medicare Advantage |
$5.73
|
| Rate for Payer: Cash Price |
$15,552.46
|
| Rate for Payer: Cash Price |
$15,552.46
|
| Rate for Payer: Cofinity Advantage |
$13,608.41
|
| Rate for Payer: Cofinity Commercial |
$16,718.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,552.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.73
|
| Rate for Payer: Healthscope Commercial |
$17,496.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,608.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,580.43
|
| Rate for Payer: Mclaren Medicaid |
$5.73
|
| Rate for Payer: Mclaren Medicare |
$5.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.02
|
| Rate for Payer: Meridian Medicaid |
$6.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,524.49
|
| Rate for Payer: Nomi Health Commercial |
$17.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,580.43
|
| Rate for Payer: PACE Medicare |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.73
|
| Rate for Payer: PHP Commercial |
$16,524.49
|
| Rate for Payer: PHP Medicare Advantage |
$5.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.08
|
| Rate for Payer: Priority Health Medicare |
$5.73
|
| Rate for Payer: Priority Health SBD |
$12,247.57
|
| Rate for Payer: Priority Health Tiered Network |
$14.46
|
| Rate for Payer: Railroad Medicare Medicare |
$5.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.45
|
| Rate for Payer: UHC Core |
$9.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.73
|
| Rate for Payer: UHC Exchange |
$9.45
|
| Rate for Payer: UHC Medicaid |
$3.00
|
| Rate for Payer: UHCCP Medicaid |
$3.00
|
| Rate for Payer: UMR Bronson Commercial |
$7,193.01
|
| Rate for Payer: VA VA |
$5.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,580.43
|
|
|
NECITUMUMAB 800 MG/50 ML (16 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19,440.58
|
|
|
Service Code
|
HCPCS J9295
|
| Hospital Charge Code |
176602
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8,553.86 |
| Max. Negotiated Rate |
$17,496.52 |
| Rate for Payer: Aetna American Axle |
$12,636.38
|
| Rate for Payer: Aetna Commercial |
$16,524.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,636.38
|
| Rate for Payer: Cash Price |
$15,552.46
|
| Rate for Payer: Cofinity Advantage |
$13,608.41
|
| Rate for Payer: Cofinity Commercial |
$16,718.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,552.46
|
| Rate for Payer: Healthscope Commercial |
$17,496.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,608.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,580.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,524.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,580.43
|
| Rate for Payer: PHP Commercial |
$16,524.49
|
| Rate for Payer: Priority Health SBD |
$12,247.57
|
| Rate for Payer: UMR Bronson Commercial |
$8,553.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,580.43
|
|
|
NEGATIVE PRESSURE WOUND THERAPY, (EG, VACUUM ASSISTED DRAINAGE COLLECTION), UTILIZING DISPOSABLE, NON-DURABLE MEDICAL EQUIPMENT INCLUDING PROVISION OF EXUDATE MANAGEMENT COLLECTION SYSTEM, TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTIONS FOR ONGOING CARE, PER SESSION; TOTAL WOUND(S) SURFACE AREA LESS THAN OR EQUAL TO 50 SQUARE CENTIMETERS
|
Facility
|
OP
|
$1,309.90
|
|
|
Service Code
|
CPT 97607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$720.95
|
| Rate for Payer: BCN Commercial |
$720.95
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
NEGATIVE PRESSURE WOUND THERAPY (EG, VACUUM ASSISTED DRAINAGE COLLECTION), UTILIZING DURABLE MEDICAL EQUIPMENT (DME), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION; TOTAL WOUND(S) SURFACE AREA GREATER THAN 50 SQUARE CENTIMETERS
|
Facility
|
OP
|
$1,309.90
|
|
|
Service Code
|
CPT 97606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$111.86 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$111.86
|
| Rate for Payer: BCN Commercial |
$111.86
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
NEGATIVE PRESSURE WOUND THERAPY (EG, VACUUM ASSISTED DRAINAGE COLLECTION), UTILIZING DURABLE MEDICAL EQUIPMENT (DME), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION; TOTAL WOUND(S) SURFACE AREA LESS THAN OR EQUAL TO 50 SQUARE CENTIMETERS
|
Facility
|
OP
|
$646.50
|
|
|
Service Code
|
CPT 97605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$103.17 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$103.17
|
| Rate for Payer: BCN Commercial |
$103.17
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
NELARABINE 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$9,849.38
|
|
|
Service Code
|
HCPCS J9261
|
| Hospital Charge Code |
70267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4,333.73 |
| Max. Negotiated Rate |
$8,864.44 |
| Rate for Payer: Aetna American Axle |
$6,402.10
|
| Rate for Payer: Aetna American Axle |
$3,110.38
|
| Rate for Payer: Aetna American Axle |
$2,695.42
|
| Rate for Payer: Aetna American Axle |
$2,228.59
|
| Rate for Payer: Aetna American Axle |
$2,200.38
|
| Rate for Payer: Aetna American Axle |
$3,962.14
|
| Rate for Payer: Aetna American Axle |
$3,910.89
|
| Rate for Payer: Aetna American Axle |
$3,723.72
|
| Rate for Payer: Aetna American Axle |
$2,002.00
|
| Rate for Payer: Aetna American Axle |
$3,981.25
|
| Rate for Payer: Aetna American Axle |
$4,273.36
|
| Rate for Payer: Aetna American Axle |
$4,399.85
|
| Rate for Payer: Aetna Commercial |
$4,067.42
|
| Rate for Payer: Aetna Commercial |
$5,753.65
|
| Rate for Payer: Aetna Commercial |
$5,588.24
|
| Rate for Payer: Aetna Commercial |
$8,371.97
|
| Rate for Payer: Aetna Commercial |
$5,206.25
|
| Rate for Payer: Aetna Commercial |
$2,914.31
|
| Rate for Payer: Aetna Commercial |
$4,869.48
|
| Rate for Payer: Aetna Commercial |
$3,524.78
|
| Rate for Payer: Aetna Commercial |
$2,877.42
|
| Rate for Payer: Aetna Commercial |
$5,114.24
|
| Rate for Payer: Aetna Commercial |
$2,618.00
|
| Rate for Payer: Aetna Commercial |
$5,181.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,695.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,910.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,228.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,200.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,002.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,402.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,399.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,273.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,110.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,981.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,723.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,962.14
|
| Rate for Payer: Cash Price |
$4,900.00
|
| Rate for Payer: Cash Price |
$5,415.20
|
| Rate for Payer: Cash Price |
$3,317.44
|
| Rate for Payer: Cash Price |
$7,879.50
|
| Rate for Payer: Cash Price |
$4,583.04
|
| Rate for Payer: Cash Price |
$2,742.88
|
| Rate for Payer: Cash Price |
$2,708.16
|
| Rate for Payer: Cash Price |
$4,813.40
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cash Price |
$5,259.52
|
| Rate for Payer: Cash Price |
$4,876.48
|
| Rate for Payer: Cash Price |
$3,828.16
|
| Rate for Payer: Cofinity Advantage |
$2,156.00
|
| Rate for Payer: Cofinity Advantage |
$4,211.73
|
| Rate for Payer: Cofinity Advantage |
$4,010.16
|
| Rate for Payer: Cofinity Advantage |
$4,287.50
|
| Rate for Payer: Cofinity Advantage |
$2,902.76
|
| Rate for Payer: Cofinity Advantage |
$2,369.64
|
| Rate for Payer: Cofinity Advantage |
$3,349.64
|
| Rate for Payer: Cofinity Advantage |
$6,894.57
|
| Rate for Payer: Cofinity Advantage |
$4,738.30
|
| Rate for Payer: Cofinity Advantage |
$4,266.92
|
| Rate for Payer: Cofinity Advantage |
$4,602.08
|
| Rate for Payer: Cofinity Advantage |
$2,400.02
|
| Rate for Payer: Cofinity Commercial |
$3,566.25
|
| Rate for Payer: Cofinity Commercial |
$8,470.47
|
| Rate for Payer: Cofinity Commercial |
$5,242.22
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Cofinity Commercial |
$5,821.34
|
| Rate for Payer: Cofinity Commercial |
$2,911.27
|
| Rate for Payer: Cofinity Commercial |
$2,648.80
|
| Rate for Payer: Cofinity Commercial |
$5,653.98
|
| Rate for Payer: Cofinity Commercial |
$5,267.50
|
| Rate for Payer: Cofinity Commercial |
$4,115.27
|
| Rate for Payer: Cofinity Commercial |
$4,926.77
|
| Rate for Payer: Cofinity Commercial |
$5,174.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,415.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,464.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,583.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,259.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,317.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,876.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,900.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,742.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,708.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,828.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,879.50
|
| Rate for Payer: Healthscope Commercial |
$4,306.68
|
| Rate for Payer: Healthscope Commercial |
$5,512.50
|
| Rate for Payer: Healthscope Commercial |
$5,916.96
|
| Rate for Payer: Healthscope Commercial |
$5,486.04
|
| Rate for Payer: Healthscope Commercial |
$6,092.10
|
| Rate for Payer: Healthscope Commercial |
$8,864.44
|
| Rate for Payer: Healthscope Commercial |
$5,155.92
|
| Rate for Payer: Healthscope Commercial |
$2,772.00
|
| Rate for Payer: Healthscope Commercial |
$3,732.12
|
| Rate for Payer: Healthscope Commercial |
$3,046.68
|
| Rate for Payer: Healthscope Commercial |
$3,085.74
|
| Rate for Payer: Healthscope Commercial |
$5,415.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,266.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,156.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,400.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,369.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,902.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,349.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,010.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,211.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,287.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,602.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,738.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,894.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,588.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,296.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,593.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,387.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,076.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,538.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,571.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,571.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,110.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,310.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,512.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,930.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,524.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,914.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,877.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,869.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,618.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,181.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,588.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,371.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,753.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,067.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,310.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,571.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,538.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,930.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,512.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,571.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,588.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,076.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,387.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,593.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,110.10
|
| Rate for Payer: PHP Commercial |
$5,206.25
|
| Rate for Payer: PHP Commercial |
$4,869.48
|
| Rate for Payer: PHP Commercial |
$5,181.26
|
| Rate for Payer: PHP Commercial |
$4,067.42
|
| Rate for Payer: PHP Commercial |
$8,371.97
|
| Rate for Payer: PHP Commercial |
$5,114.24
|
| Rate for Payer: PHP Commercial |
$5,588.24
|
| Rate for Payer: PHP Commercial |
$3,524.78
|
| Rate for Payer: PHP Commercial |
$2,618.00
|
| Rate for Payer: PHP Commercial |
$2,877.42
|
| Rate for Payer: PHP Commercial |
$2,914.31
|
| Rate for Payer: PHP Commercial |
$5,753.65
|
| Rate for Payer: Priority Health SBD |
$3,609.14
|
| Rate for Payer: Priority Health SBD |
$2,132.68
|
| Rate for Payer: Priority Health SBD |
$3,858.75
|
| Rate for Payer: Priority Health SBD |
$2,612.48
|
| Rate for Payer: Priority Health SBD |
$3,790.55
|
| Rate for Payer: Priority Health SBD |
$4,264.47
|
| Rate for Payer: Priority Health SBD |
$4,141.87
|
| Rate for Payer: Priority Health SBD |
$2,160.02
|
| Rate for Payer: Priority Health SBD |
$3,014.68
|
| Rate for Payer: Priority Health SBD |
$3,840.23
|
| Rate for Payer: Priority Health SBD |
$1,940.40
|
| Rate for Payer: Priority Health SBD |
$6,205.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,489.49
|
| Rate for Payer: UMR Bronson Commercial |
$2,892.74
|
| Rate for Payer: UMR Bronson Commercial |
$2,520.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,647.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,824.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,355.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,508.58
|
| Rate for Payer: UMR Bronson Commercial |
$4,333.73
|
| Rate for Payer: UMR Bronson Commercial |
$2,695.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,978.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,682.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,105.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,296.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,310.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,538.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,930.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,387.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,588.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,076.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,571.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,593.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,512.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,110.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,571.70
|
|
|
NELARABINE 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$9,849.38
|
|
|
Service Code
|
HCPCS J9261
|
| Hospital Charge Code |
70267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.57 |
| Max. Negotiated Rate |
$8,864.44 |
| Rate for Payer: Aetna American Axle |
$6,402.10
|
| Rate for Payer: Aetna American Axle |
$2,200.38
|
| Rate for Payer: Aetna American Axle |
$4,399.85
|
| Rate for Payer: Aetna American Axle |
$3,723.72
|
| Rate for Payer: Aetna American Axle |
$2,695.42
|
| Rate for Payer: Aetna American Axle |
$2,228.59
|
| Rate for Payer: Aetna American Axle |
$3,110.38
|
| Rate for Payer: Aetna American Axle |
$3,962.14
|
| Rate for Payer: Aetna American Axle |
$4,273.36
|
| Rate for Payer: Aetna American Axle |
$2,002.00
|
| Rate for Payer: Aetna American Axle |
$3,981.25
|
| Rate for Payer: Aetna American Axle |
$3,910.89
|
| Rate for Payer: Aetna Commercial |
$5,114.24
|
| Rate for Payer: Aetna Commercial |
$5,753.65
|
| Rate for Payer: Aetna Commercial |
$2,877.42
|
| Rate for Payer: Aetna Commercial |
$5,181.26
|
| Rate for Payer: Aetna Commercial |
$5,206.25
|
| Rate for Payer: Aetna Commercial |
$2,618.00
|
| Rate for Payer: Aetna Commercial |
$4,067.42
|
| Rate for Payer: Aetna Commercial |
$5,588.24
|
| Rate for Payer: Aetna Commercial |
$3,524.78
|
| Rate for Payer: Aetna Commercial |
$2,914.31
|
| Rate for Payer: Aetna Commercial |
$8,371.97
|
| Rate for Payer: Aetna Commercial |
$4,869.48
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna Medicare |
$54.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,110.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,402.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,228.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,399.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,723.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,910.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,273.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,962.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,981.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,695.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,200.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,002.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.89
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS Complete |
$28.95
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS MAPPO |
$52.71
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Commercial |
$211.26
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$52.71
|
| Rate for Payer: Cash Price |
$4,813.40
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cash Price |
$2,464.00
|
| Rate for Payer: Cash Price |
$2,708.16
|
| Rate for Payer: Cash Price |
$5,259.52
|
| Rate for Payer: Cash Price |
$4,900.00
|
| Rate for Payer: Cash Price |
$7,879.50
|
| Rate for Payer: Cash Price |
$2,708.16
|
| Rate for Payer: Cash Price |
$2,742.88
|
| Rate for Payer: Cash Price |
$4,900.00
|
| Rate for Payer: Cash Price |
$2,742.88
|
| Rate for Payer: Cash Price |
$3,317.44
|
| Rate for Payer: Cash Price |
$4,876.48
|
| Rate for Payer: Cash Price |
$5,415.20
|
| Rate for Payer: Cash Price |
$7,879.50
|
| Rate for Payer: Cash Price |
$3,317.44
|
| Rate for Payer: Cash Price |
$3,828.16
|
| Rate for Payer: Cash Price |
$5,259.52
|
| Rate for Payer: Cash Price |
$4,876.48
|
| Rate for Payer: Cash Price |
$3,828.16
|
| Rate for Payer: Cash Price |
$4,583.04
|
| Rate for Payer: Cash Price |
$4,813.40
|
| Rate for Payer: Cash Price |
$5,415.20
|
| Rate for Payer: Cash Price |
$4,583.04
|
| Rate for Payer: Cofinity Advantage |
$2,902.76
|
| Rate for Payer: Cofinity Advantage |
$2,400.02
|
| Rate for Payer: Cofinity Advantage |
$4,602.08
|
| Rate for Payer: Cofinity Advantage |
$4,211.73
|
| Rate for Payer: Cofinity Advantage |
$4,738.30
|
| Rate for Payer: Cofinity Advantage |
$2,156.00
|
| Rate for Payer: Cofinity Advantage |
$4,287.50
|
| Rate for Payer: Cofinity Advantage |
$3,349.64
|
| Rate for Payer: Cofinity Advantage |
$4,266.92
|
| Rate for Payer: Cofinity Advantage |
$6,894.57
|
| Rate for Payer: Cofinity Advantage |
$4,010.16
|
| Rate for Payer: Cofinity Advantage |
$2,369.64
|
| Rate for Payer: Cofinity Commercial |
$5,242.22
|
| Rate for Payer: Cofinity Commercial |
$3,566.25
|
| Rate for Payer: Cofinity Commercial |
$4,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,648.80
|
| Rate for Payer: Cofinity Commercial |
$5,174.40
|
| Rate for Payer: Cofinity Commercial |
$5,267.50
|
| Rate for Payer: Cofinity Commercial |
$5,821.34
|
| Rate for Payer: Cofinity Commercial |
$2,948.60
|
| Rate for Payer: Cofinity Commercial |
$8,470.47
|
| Rate for Payer: Cofinity Commercial |
$5,653.98
|
| Rate for Payer: Cofinity Commercial |
$4,926.77
|
| Rate for Payer: Cofinity Commercial |
$2,911.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,879.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,900.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,742.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,583.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,876.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,259.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,464.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,317.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,415.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,708.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,828.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.71
|
| Rate for Payer: Healthscope Commercial |
$2,772.00
|
| Rate for Payer: Healthscope Commercial |
$5,916.96
|
| Rate for Payer: Healthscope Commercial |
$3,732.12
|
| Rate for Payer: Healthscope Commercial |
$3,046.68
|
| Rate for Payer: Healthscope Commercial |
$6,092.10
|
| Rate for Payer: Healthscope Commercial |
$5,155.92
|
| Rate for Payer: Healthscope Commercial |
$4,306.68
|
| Rate for Payer: Healthscope Commercial |
$8,864.44
|
| Rate for Payer: Healthscope Commercial |
$5,486.04
|
| Rate for Payer: Healthscope Commercial |
$3,085.74
|
| Rate for Payer: Healthscope Commercial |
$5,512.50
|
| Rate for Payer: Healthscope Commercial |
$5,415.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,738.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,902.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,369.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,010.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,894.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,287.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,349.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,211.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,602.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,156.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,266.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,400.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,387.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,930.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,076.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,571.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,538.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,593.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,310.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,110.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,512.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,571.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,588.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,296.60
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicaid |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Mclaren Medicare |
$52.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: Meridian Medicaid |
$55.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,371.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,869.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,618.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,181.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,914.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,067.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,753.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,877.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,588.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,524.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,206.25
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Nomi Health Commercial |
$158.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,110.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,571.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,571.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,512.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,930.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,538.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,588.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,593.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,076.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,387.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,310.00
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE Medicare |
$50.07
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PACE SWMI |
$52.71
|
| Rate for Payer: PHP Commercial |
$5,114.24
|
| Rate for Payer: PHP Commercial |
$3,524.78
|
| Rate for Payer: PHP Commercial |
$5,206.25
|
| Rate for Payer: PHP Commercial |
$5,588.24
|
| Rate for Payer: PHP Commercial |
$5,753.65
|
| Rate for Payer: PHP Commercial |
$2,618.00
|
| Rate for Payer: PHP Commercial |
$2,877.42
|
| Rate for Payer: PHP Commercial |
$8,371.97
|
| Rate for Payer: PHP Commercial |
$2,914.31
|
| Rate for Payer: PHP Commercial |
$4,067.42
|
| Rate for Payer: PHP Commercial |
$4,869.48
|
| Rate for Payer: PHP Commercial |
$5,181.26
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: PHP Medicare Advantage |
$52.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$251.88
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health Medicare |
$52.71
|
| Rate for Payer: Priority Health SBD |
$4,264.47
|
| Rate for Payer: Priority Health SBD |
$2,612.48
|
| Rate for Payer: Priority Health SBD |
$3,790.55
|
| Rate for Payer: Priority Health SBD |
$3,014.68
|
| Rate for Payer: Priority Health SBD |
$6,205.11
|
| Rate for Payer: Priority Health SBD |
$4,141.87
|
| Rate for Payer: Priority Health SBD |
$3,840.23
|
| Rate for Payer: Priority Health SBD |
$2,160.02
|
| Rate for Payer: Priority Health SBD |
$2,132.68
|
| Rate for Payer: Priority Health SBD |
$3,858.75
|
| Rate for Payer: Priority Health SBD |
$3,609.14
|
| Rate for Payer: Priority Health SBD |
$1,940.40
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Priority Health Tiered Network |
$201.50
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.71
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHC Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$27.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,268.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,226.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,139.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,252.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,504.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,432.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,770.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,534.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,266.25
|
| Rate for Payer: UMR Bronson Commercial |
$2,255.37
|
| Rate for Payer: UMR Bronson Commercial |
$3,644.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,119.66
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: VA VA |
$52.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,593.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,310.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,110.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,512.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,387.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,538.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,296.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,571.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,076.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,588.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,571.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,930.80
|
|
|
NELFINAVIR 250 MG TABLET
|
Facility
|
OP
|
$4,380.06
|
|
|
Service Code
|
NDC 63010001030
|
| Hospital Charge Code |
20032
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,620.62 |
| Max. Negotiated Rate |
$3,942.05 |
| Rate for Payer: Aetna American Axle |
$2,847.04
|
| Rate for Payer: Aetna Commercial |
$3,723.05
|
| Rate for Payer: Aetna Medicare |
$2,190.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,847.04
|
| Rate for Payer: BCBS Complete |
$1,752.02
|
| Rate for Payer: Cash Price |
$3,504.05
|
| Rate for Payer: Cofinity Advantage |
$3,066.04
|
| Rate for Payer: Cofinity Commercial |
$3,766.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,504.05
|
| Rate for Payer: Healthscope Commercial |
$3,942.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,066.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,285.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,504.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,723.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,285.05
|
| Rate for Payer: PHP Commercial |
$3,723.05
|
| Rate for Payer: Priority Health SBD |
$2,759.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.04
|
| Rate for Payer: UHC Core |
$2,282.01
|
| Rate for Payer: UHC Exchange |
$1,721.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,620.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,285.05
|
|
|
NELFINAVIR 250 MG TABLET
|
Facility
|
IP
|
$4,380.06
|
|
|
Service Code
|
NDC 63010001030
|
| Hospital Charge Code |
20032
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,927.23 |
| Max. Negotiated Rate |
$3,942.05 |
| Rate for Payer: Aetna American Axle |
$2,847.04
|
| Rate for Payer: Aetna Commercial |
$3,723.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,847.04
|
| Rate for Payer: Cash Price |
$3,504.05
|
| Rate for Payer: Cofinity Advantage |
$3,066.04
|
| Rate for Payer: Cofinity Commercial |
$3,766.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,504.05
|
| Rate for Payer: Healthscope Commercial |
$3,942.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,066.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,285.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,723.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,285.05
|
| Rate for Payer: PHP Commercial |
$3,723.05
|
| Rate for Payer: Priority Health SBD |
$2,759.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,927.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,285.05
|
|
|
NEOMY-BACIT-POLYMYX-PRAMOXINE 3.5 MG-500 UNIT-10,000 UNIT/G TOP OINT
|
Facility
|
IP
|
$44.31
|
|
|
Service Code
|
NDC 00713062231
|
| Hospital Charge Code |
21070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$39.88 |
| Rate for Payer: Aetna American Axle |
$28.80
|
| Rate for Payer: Aetna Commercial |
$37.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.80
|
| Rate for Payer: Cash Price |
$35.45
|
| Rate for Payer: Cofinity Advantage |
$31.02
|
| Rate for Payer: Cofinity Commercial |
$38.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.45
|
| Rate for Payer: Healthscope Commercial |
$39.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.23
|
| Rate for Payer: PHP Commercial |
$37.66
|
| Rate for Payer: Priority Health SBD |
$27.92
|
| Rate for Payer: UMR Bronson Commercial |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.23
|
|
