|
OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE
|
Facility
|
OP
|
$11,585.32
|
|
|
Service Code
|
HCPCS J2353
|
| Hospital Charge Code |
161512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$98.51 |
| Max. Negotiated Rate |
$10,426.79 |
| Rate for Payer: Aetna American Axle |
$7,530.46
|
| Rate for Payer: Aetna Commercial |
$9,847.52
|
| Rate for Payer: Aetna Medicare |
$195.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,530.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.44
|
| Rate for Payer: BCBS Complete |
$103.44
|
| Rate for Payer: BCBS MAPPO |
$188.35
|
| Rate for Payer: BCBS Trust/PPO |
$645.81
|
| Rate for Payer: BCN Commercial |
$645.81
|
| Rate for Payer: BCN Medicare Advantage |
$188.35
|
| Rate for Payer: Cash Price |
$9,268.26
|
| Rate for Payer: Cash Price |
$9,268.26
|
| Rate for Payer: Cofinity Advantage |
$8,109.72
|
| Rate for Payer: Cofinity Commercial |
$9,963.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,268.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.35
|
| Rate for Payer: Healthscope Commercial |
$10,426.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,109.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,688.99
|
| Rate for Payer: Mclaren Medicaid |
$188.35
|
| Rate for Payer: Mclaren Medicare |
$188.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.77
|
| Rate for Payer: Meridian Medicaid |
$197.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,847.52
|
| Rate for Payer: Nomi Health Commercial |
$565.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,688.99
|
| Rate for Payer: PACE Medicare |
$178.93
|
| Rate for Payer: PACE SWMI |
$188.35
|
| Rate for Payer: PHP Commercial |
$9,847.52
|
| Rate for Payer: PHP Medicare Advantage |
$188.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$642.09
|
| Rate for Payer: Priority Health Medicare |
$188.35
|
| Rate for Payer: Priority Health SBD |
$7,298.75
|
| Rate for Payer: Priority Health Tiered Network |
$513.67
|
| Rate for Payer: Railroad Medicare Medicare |
$188.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.63
|
| Rate for Payer: UHC Core |
$328.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.35
|
| Rate for Payer: UHC Exchange |
$328.63
|
| Rate for Payer: UHC Medicaid |
$98.51
|
| Rate for Payer: UHCCP Medicaid |
$98.51
|
| Rate for Payer: UMR Bronson Commercial |
$4,286.57
|
| Rate for Payer: VA VA |
$188.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,688.99
|
|
|
OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE
|
Facility
|
IP
|
$11,585.32
|
|
|
Service Code
|
HCPCS J2353
|
| Hospital Charge Code |
161512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5,097.54 |
| Max. Negotiated Rate |
$10,426.79 |
| Rate for Payer: Aetna American Axle |
$7,530.46
|
| Rate for Payer: Aetna Commercial |
$9,847.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,530.46
|
| Rate for Payer: Cash Price |
$9,268.26
|
| Rate for Payer: Cofinity Advantage |
$8,109.72
|
| Rate for Payer: Cofinity Commercial |
$9,963.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,268.26
|
| Rate for Payer: Healthscope Commercial |
$10,426.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,109.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,688.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,847.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,688.99
|
| Rate for Payer: PHP Commercial |
$9,847.52
|
| Rate for Payer: Priority Health SBD |
$7,298.75
|
| Rate for Payer: UMR Bronson Commercial |
$5,097.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,688.99
|
|
|
OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE
|
Facility
|
IP
|
$17,348.09
|
|
|
Service Code
|
HCPCS J2353
|
| Hospital Charge Code |
161514
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,633.16 |
| Max. Negotiated Rate |
$15,613.28 |
| Rate for Payer: Aetna American Axle |
$11,276.26
|
| Rate for Payer: Aetna Commercial |
$14,745.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,276.26
|
| Rate for Payer: Cash Price |
$13,878.47
|
| Rate for Payer: Cofinity Advantage |
$12,143.66
|
| Rate for Payer: Cofinity Commercial |
$14,919.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,878.47
|
| Rate for Payer: Healthscope Commercial |
$15,613.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,143.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,011.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,745.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,011.07
|
| Rate for Payer: PHP Commercial |
$14,745.88
|
| Rate for Payer: Priority Health SBD |
$10,929.30
|
| Rate for Payer: UMR Bronson Commercial |
$7,633.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,011.07
|
|
|
OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE
|
Facility
|
OP
|
$17,348.09
|
|
|
Service Code
|
HCPCS J2353
|
| Hospital Charge Code |
161514
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$98.51 |
| Max. Negotiated Rate |
$15,613.28 |
| Rate for Payer: Aetna American Axle |
$11,276.26
|
| Rate for Payer: Aetna Commercial |
$14,745.88
|
| Rate for Payer: Aetna Medicare |
$195.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,276.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.44
|
| Rate for Payer: BCBS Complete |
$103.44
|
| Rate for Payer: BCBS MAPPO |
$188.35
|
| Rate for Payer: BCBS Trust/PPO |
$645.81
|
| Rate for Payer: BCN Commercial |
$645.81
|
| Rate for Payer: BCN Medicare Advantage |
$188.35
|
| Rate for Payer: Cash Price |
$13,878.47
|
| Rate for Payer: Cash Price |
$13,878.47
|
| Rate for Payer: Cofinity Advantage |
$12,143.66
|
| Rate for Payer: Cofinity Commercial |
$14,919.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,878.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.35
|
| Rate for Payer: Healthscope Commercial |
$15,613.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,143.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,011.07
|
| Rate for Payer: Mclaren Medicaid |
$188.35
|
| Rate for Payer: Mclaren Medicare |
$188.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.77
|
| Rate for Payer: Meridian Medicaid |
$197.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,745.88
|
| Rate for Payer: Nomi Health Commercial |
$565.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,011.07
|
| Rate for Payer: PACE Medicare |
$178.93
|
| Rate for Payer: PACE SWMI |
$188.35
|
| Rate for Payer: PHP Commercial |
$14,745.88
|
| Rate for Payer: PHP Medicare Advantage |
$188.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$642.09
|
| Rate for Payer: Priority Health Medicare |
$188.35
|
| Rate for Payer: Priority Health SBD |
$10,929.30
|
| Rate for Payer: Priority Health Tiered Network |
$513.67
|
| Rate for Payer: Railroad Medicare Medicare |
$188.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.63
|
| Rate for Payer: UHC Core |
$328.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.35
|
| Rate for Payer: UHC Exchange |
$328.63
|
| Rate for Payer: UHC Medicaid |
$98.51
|
| Rate for Payer: UHCCP Medicaid |
$98.51
|
| Rate for Payer: UMR Bronson Commercial |
$6,418.79
|
| Rate for Payer: VA VA |
$188.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,011.07
|
|
|
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$2,641.40
|
|
|
Service Code
|
HCPCS J9302
|
| Hospital Charge Code |
100265
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,162.22 |
| Max. Negotiated Rate |
$2,377.26 |
| Rate for Payer: Aetna American Axle |
$1,716.91
|
| Rate for Payer: Aetna Commercial |
$2,245.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,716.91
|
| Rate for Payer: Cash Price |
$2,113.12
|
| Rate for Payer: Cofinity Advantage |
$1,848.98
|
| Rate for Payer: Cofinity Commercial |
$2,271.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,113.12
|
| Rate for Payer: Healthscope Commercial |
$2,377.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,848.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,981.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,245.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,981.05
|
| Rate for Payer: PHP Commercial |
$2,245.19
|
| Rate for Payer: Priority Health SBD |
$1,664.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,162.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,981.05
|
|
|
OFATUMUMAB 100 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$2,641.40
|
|
|
Service Code
|
HCPCS J9302
|
| Hospital Charge Code |
100265
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$2,377.26 |
| Rate for Payer: Aetna American Axle |
$1,716.91
|
| Rate for Payer: Aetna Commercial |
$2,245.19
|
| Rate for Payer: Aetna Medicare |
$64.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,716.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.79
|
| Rate for Payer: BCBS Complete |
$34.18
|
| Rate for Payer: BCBS MAPPO |
$62.23
|
| Rate for Payer: BCBS Trust/PPO |
$195.32
|
| Rate for Payer: BCN Commercial |
$195.32
|
| Rate for Payer: BCN Medicare Advantage |
$62.23
|
| Rate for Payer: Cash Price |
$2,113.12
|
| Rate for Payer: Cash Price |
$2,113.12
|
| Rate for Payer: Cofinity Advantage |
$1,848.98
|
| Rate for Payer: Cofinity Commercial |
$2,271.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,113.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.23
|
| Rate for Payer: Healthscope Commercial |
$2,377.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,848.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,981.05
|
| Rate for Payer: Mclaren Medicaid |
$62.23
|
| Rate for Payer: Mclaren Medicare |
$62.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.34
|
| Rate for Payer: Meridian Medicaid |
$65.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,245.19
|
| Rate for Payer: Nomi Health Commercial |
$186.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,981.05
|
| Rate for Payer: PACE Medicare |
$59.12
|
| Rate for Payer: PACE SWMI |
$62.23
|
| Rate for Payer: PHP Commercial |
$2,245.19
|
| Rate for Payer: PHP Medicare Advantage |
$62.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$196.29
|
| Rate for Payer: Priority Health Medicare |
$62.23
|
| Rate for Payer: Priority Health SBD |
$1,664.08
|
| Rate for Payer: Priority Health Tiered Network |
$157.03
|
| Rate for Payer: Railroad Medicare Medicare |
$62.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.68
|
| Rate for Payer: UHC Core |
$102.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.23
|
| Rate for Payer: UHC Exchange |
$102.68
|
| Rate for Payer: UHC Medicaid |
$32.55
|
| Rate for Payer: UHCCP Medicaid |
$32.55
|
| Rate for Payer: UMR Bronson Commercial |
$977.32
|
| Rate for Payer: VA VA |
$62.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,981.05
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
OP
|
$97.65
|
|
|
Service Code
|
NDC 64980051501
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$87.89 |
| Rate for Payer: Aetna American Axle |
$63.47
|
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: Aetna Medicare |
$48.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.47
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cofinity Advantage |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.12
|
| Rate for Payer: Healthscope Commercial |
$87.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.24
|
| Rate for Payer: PHP Commercial |
$83.00
|
| Rate for Payer: Priority Health SBD |
$61.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.47
|
| Rate for Payer: UHC Core |
$50.88
|
| Rate for Payer: UHC Exchange |
$38.38
|
| Rate for Payer: UMR Bronson Commercial |
$36.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.24
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$105.14
|
|
|
Service Code
|
NDC 60505056001
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.26 |
| Max. Negotiated Rate |
$94.63 |
| Rate for Payer: Aetna American Axle |
$68.34
|
| Rate for Payer: Aetna Commercial |
$89.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.34
|
| Rate for Payer: Cash Price |
$84.11
|
| Rate for Payer: Cofinity Advantage |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$90.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.11
|
| Rate for Payer: Healthscope Commercial |
$94.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.86
|
| Rate for Payer: PHP Commercial |
$89.37
|
| Rate for Payer: Priority Health SBD |
$66.24
|
| Rate for Payer: UMR Bronson Commercial |
$46.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.86
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
OP
|
$105.14
|
|
|
Service Code
|
NDC 60505056001
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.90 |
| Max. Negotiated Rate |
$94.63 |
| Rate for Payer: Aetna American Axle |
$68.34
|
| Rate for Payer: Aetna Commercial |
$89.37
|
| Rate for Payer: Aetna Medicare |
$52.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.34
|
| Rate for Payer: BCBS Complete |
$42.06
|
| Rate for Payer: Cash Price |
$84.11
|
| Rate for Payer: Cofinity Advantage |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$90.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.11
|
| Rate for Payer: Healthscope Commercial |
$94.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.86
|
| Rate for Payer: PHP Commercial |
$89.37
|
| Rate for Payer: Priority Health SBD |
$66.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.34
|
| Rate for Payer: UHC Core |
$54.78
|
| Rate for Payer: UHC Exchange |
$41.32
|
| Rate for Payer: UMR Bronson Commercial |
$38.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.86
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
NDC 64980051505
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$24.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: BCBS Complete |
$19.53
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.74
|
| Rate for Payer: UHC Core |
$25.44
|
| Rate for Payer: UHC Exchange |
$19.19
|
| Rate for Payer: UMR Bronson Commercial |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
OP
|
$31.29
|
|
|
Service Code
|
NDC 70756060730
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$28.16 |
| Rate for Payer: Aetna American Axle |
$20.34
|
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: Aetna Medicare |
$15.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.34
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Advantage |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$26.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$28.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.47
|
| Rate for Payer: PHP Commercial |
$26.60
|
| Rate for Payer: Priority Health SBD |
$19.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.34
|
| Rate for Payer: UHC Core |
$16.30
|
| Rate for Payer: UHC Exchange |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.47
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$31.29
|
|
|
Service Code
|
NDC 70756060730
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$28.16 |
| Rate for Payer: Aetna American Axle |
$20.34
|
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.34
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Advantage |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$26.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$28.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.47
|
| Rate for Payer: PHP Commercial |
$26.60
|
| Rate for Payer: Priority Health SBD |
$19.71
|
| Rate for Payer: UMR Bronson Commercial |
$13.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.47
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$97.65
|
|
|
Service Code
|
NDC 64980051501
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.97 |
| Max. Negotiated Rate |
$87.89 |
| Rate for Payer: Aetna American Axle |
$63.47
|
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.47
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cofinity Advantage |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.12
|
| Rate for Payer: Healthscope Commercial |
$87.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.24
|
| Rate for Payer: PHP Commercial |
$83.00
|
| Rate for Payer: Priority Health SBD |
$61.52
|
| Rate for Payer: UMR Bronson Commercial |
$42.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.24
|
|
|
OFLOXACIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
NDC 64980051505
|
| Hospital Charge Code |
19746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$5.62
|
|
|
Service Code
|
NDC 49884032152
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$5.06 |
| Rate for Payer: Aetna American Axle |
$3.65
|
| Rate for Payer: Aetna Commercial |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.65
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cofinity Advantage |
$3.93
|
| Rate for Payer: Cofinity Commercial |
$4.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.50
|
| Rate for Payer: Healthscope Commercial |
$5.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.21
|
| Rate for Payer: PHP Commercial |
$4.78
|
| Rate for Payer: Priority Health SBD |
$3.54
|
| Rate for Payer: UMR Bronson Commercial |
$2.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.21
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$168.34
|
|
|
Service Code
|
NDC 49884032155
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.07 |
| Max. Negotiated Rate |
$151.51 |
| Rate for Payer: Aetna American Axle |
$109.42
|
| Rate for Payer: Aetna Commercial |
$143.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.42
|
| Rate for Payer: Cash Price |
$134.67
|
| Rate for Payer: Cofinity Advantage |
$117.84
|
| Rate for Payer: Cofinity Commercial |
$144.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.67
|
| Rate for Payer: Healthscope Commercial |
$151.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.25
|
| Rate for Payer: PHP Commercial |
$143.09
|
| Rate for Payer: Priority Health SBD |
$106.05
|
| Rate for Payer: UMR Bronson Commercial |
$74.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.25
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$85.03
|
|
|
Service Code
|
NDC 00002445401
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.46 |
| Max. Negotiated Rate |
$76.53 |
| Rate for Payer: Aetna American Axle |
$55.27
|
| Rate for Payer: Aetna Commercial |
$72.28
|
| Rate for Payer: Aetna Medicare |
$42.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.27
|
| Rate for Payer: BCBS Complete |
$34.01
|
| Rate for Payer: Cash Price |
$68.02
|
| Rate for Payer: Cofinity Advantage |
$59.52
|
| Rate for Payer: Cofinity Commercial |
$73.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.02
|
| Rate for Payer: Healthscope Commercial |
$76.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.77
|
| Rate for Payer: PHP Commercial |
$72.28
|
| Rate for Payer: Priority Health SBD |
$53.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.27
|
| Rate for Payer: UHC Core |
$44.30
|
| Rate for Payer: UHC Exchange |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$31.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.77
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$8.75
|
|
|
Service Code
|
NDC 55111026379
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$7.88 |
| Rate for Payer: Aetna American Axle |
$5.69
|
| Rate for Payer: Aetna Commercial |
$7.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.69
|
| Rate for Payer: Cash Price |
$7.00
|
| Rate for Payer: Cofinity Advantage |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.00
|
| Rate for Payer: Healthscope Commercial |
$7.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.56
|
| Rate for Payer: PHP Commercial |
$7.44
|
| Rate for Payer: Priority Health SBD |
$5.51
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.56
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$8.75
|
|
|
Service Code
|
NDC 55111026379
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$7.88 |
| Rate for Payer: Aetna American Axle |
$5.69
|
| Rate for Payer: Aetna Commercial |
$7.44
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.69
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: Cash Price |
$7.00
|
| Rate for Payer: Cofinity Advantage |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.00
|
| Rate for Payer: Healthscope Commercial |
$7.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.56
|
| Rate for Payer: PHP Commercial |
$7.44
|
| Rate for Payer: Priority Health SBD |
$5.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.69
|
| Rate for Payer: UHC Core |
$4.56
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UMR Bronson Commercial |
$3.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.56
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$119.13
|
|
|
Service Code
|
NDC 33342008407
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.42 |
| Max. Negotiated Rate |
$107.22 |
| Rate for Payer: Aetna American Axle |
$77.43
|
| Rate for Payer: Aetna Commercial |
$101.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.43
|
| Rate for Payer: Cash Price |
$95.30
|
| Rate for Payer: Cofinity Advantage |
$83.39
|
| Rate for Payer: Cofinity Commercial |
$102.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.30
|
| Rate for Payer: Healthscope Commercial |
$107.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.35
|
| Rate for Payer: PHP Commercial |
$101.26
|
| Rate for Payer: Priority Health SBD |
$75.05
|
| Rate for Payer: UMR Bronson Commercial |
$52.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.35
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$169.35
|
|
|
Service Code
|
NDC 59746030732
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.66 |
| Max. Negotiated Rate |
$152.41 |
| Rate for Payer: Aetna American Axle |
$110.08
|
| Rate for Payer: Aetna Commercial |
$143.95
|
| Rate for Payer: Aetna Medicare |
$84.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.08
|
| Rate for Payer: BCBS Complete |
$67.74
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Cofinity Advantage |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$145.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.48
|
| Rate for Payer: Healthscope Commercial |
$152.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.01
|
| Rate for Payer: PHP Commercial |
$143.95
|
| Rate for Payer: Priority Health SBD |
$106.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.08
|
| Rate for Payer: UHC Core |
$88.23
|
| Rate for Payer: UHC Exchange |
$66.55
|
| Rate for Payer: UMR Bronson Commercial |
$62.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.01
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$168.34
|
|
|
Service Code
|
NDC 49884032155
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.29 |
| Max. Negotiated Rate |
$151.51 |
| Rate for Payer: Aetna American Axle |
$109.42
|
| Rate for Payer: Aetna Commercial |
$143.09
|
| Rate for Payer: Aetna Medicare |
$84.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.42
|
| Rate for Payer: BCBS Complete |
$67.34
|
| Rate for Payer: Cash Price |
$134.67
|
| Rate for Payer: Cofinity Advantage |
$117.84
|
| Rate for Payer: Cofinity Commercial |
$144.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.67
|
| Rate for Payer: Healthscope Commercial |
$151.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.25
|
| Rate for Payer: PHP Commercial |
$143.09
|
| Rate for Payer: Priority Health SBD |
$106.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.42
|
| Rate for Payer: UHC Core |
$87.71
|
| Rate for Payer: UHC Exchange |
$66.16
|
| Rate for Payer: UMR Bronson Commercial |
$62.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.25
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$169.35
|
|
|
Service Code
|
NDC 59746030732
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.51 |
| Max. Negotiated Rate |
$152.41 |
| Rate for Payer: Aetna American Axle |
$110.08
|
| Rate for Payer: Aetna Commercial |
$143.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.08
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Cofinity Advantage |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$145.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.48
|
| Rate for Payer: Healthscope Commercial |
$152.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.01
|
| Rate for Payer: PHP Commercial |
$143.95
|
| Rate for Payer: Priority Health SBD |
$106.69
|
| Rate for Payer: UMR Bronson Commercial |
$74.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.01
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$119.13
|
|
|
Service Code
|
NDC 33342008407
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.08 |
| Max. Negotiated Rate |
$107.22 |
| Rate for Payer: Aetna American Axle |
$77.43
|
| Rate for Payer: Aetna Commercial |
$101.26
|
| Rate for Payer: Aetna Medicare |
$59.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.43
|
| Rate for Payer: BCBS Complete |
$47.65
|
| Rate for Payer: Cash Price |
$95.30
|
| Rate for Payer: Cofinity Advantage |
$83.39
|
| Rate for Payer: Cofinity Commercial |
$102.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.30
|
| Rate for Payer: Healthscope Commercial |
$107.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.35
|
| Rate for Payer: PHP Commercial |
$101.26
|
| Rate for Payer: Priority Health SBD |
$75.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.43
|
| Rate for Payer: UHC Core |
$62.07
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UMR Bronson Commercial |
$44.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.35
|
|
|
OLANZAPINE 10 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$262.30
|
|
|
Service Code
|
NDC 55111026381
|
| Hospital Charge Code |
28160
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.05 |
| Max. Negotiated Rate |
$236.07 |
| Rate for Payer: Aetna American Axle |
$170.50
|
| Rate for Payer: Aetna Commercial |
$222.96
|
| Rate for Payer: Aetna Medicare |
$131.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.50
|
| Rate for Payer: BCBS Complete |
$104.92
|
| Rate for Payer: Cash Price |
$209.84
|
| Rate for Payer: Cofinity Advantage |
$183.61
|
| Rate for Payer: Cofinity Commercial |
$225.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.84
|
| Rate for Payer: Healthscope Commercial |
$236.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.72
|
| Rate for Payer: PHP Commercial |
$222.96
|
| Rate for Payer: Priority Health SBD |
$165.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.50
|
| Rate for Payer: UHC Core |
$136.66
|
| Rate for Payer: UHC Exchange |
$103.08
|
| Rate for Payer: UMR Bronson Commercial |
$97.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.72
|
|
