|
OTHER SMALL AND LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$12,389.19
|
|
|
Service Code
|
APR-DRG 2233
|
| Min. Negotiated Rate |
$11,799.23 |
| Max. Negotiated Rate |
$12,389.19 |
| Rate for Payer: BCBS Complete |
$12,389.19
|
| Rate for Payer: Mclaren Medicaid |
$11,799.23
|
| Rate for Payer: Meridian Medicaid |
$12,389.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,799.23
|
| Rate for Payer: UHC Medicaid |
$11,799.23
|
| Rate for Payer: UHCCP Medicaid |
$11,799.23
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$26,293.50
|
|
|
Service Code
|
APR-DRG 2224
|
| Min. Negotiated Rate |
$25,041.43 |
| Max. Negotiated Rate |
$26,293.50 |
| Rate for Payer: BCBS Complete |
$26,293.50
|
| Rate for Payer: Mclaren Medicaid |
$25,041.43
|
| Rate for Payer: Meridian Medicaid |
$26,293.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,041.43
|
| Rate for Payer: UHC Medicaid |
$25,041.43
|
| Rate for Payer: UHCCP Medicaid |
$25,041.43
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$14,603.47
|
|
|
Service Code
|
APR-DRG 2223
|
| Min. Negotiated Rate |
$13,908.06 |
| Max. Negotiated Rate |
$14,603.47 |
| Rate for Payer: BCBS Complete |
$14,603.47
|
| Rate for Payer: Mclaren Medicaid |
$13,908.06
|
| Rate for Payer: Meridian Medicaid |
$14,603.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,908.06
|
| Rate for Payer: UHC Medicaid |
$13,908.06
|
| Rate for Payer: UHCCP Medicaid |
$13,908.06
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$9,583.51
|
|
|
Service Code
|
APR-DRG 2222
|
| Min. Negotiated Rate |
$9,127.15 |
| Max. Negotiated Rate |
$9,583.51 |
| Rate for Payer: BCBS Complete |
$9,583.51
|
| Rate for Payer: Mclaren Medicaid |
$9,127.15
|
| Rate for Payer: Meridian Medicaid |
$9,583.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,127.15
|
| Rate for Payer: UHC Medicaid |
$9,127.15
|
| Rate for Payer: UHCCP Medicaid |
$9,127.15
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
|
IP
|
$5,753.61
|
|
|
Service Code
|
APR-DRG 2221
|
| Min. Negotiated Rate |
$5,479.63 |
| Max. Negotiated Rate |
$5,753.61 |
| Rate for Payer: BCBS Complete |
$5,753.61
|
| Rate for Payer: Mclaren Medicaid |
$5,479.63
|
| Rate for Payer: Meridian Medicaid |
$5,753.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,479.63
|
| Rate for Payer: UHC Medicaid |
$5,479.63
|
| Rate for Payer: UHCCP Medicaid |
$5,479.63
|
|
|
OTHER UPPER VASCULAR PROCEDURES
|
Facility
|
IP
|
$17,140.38
|
|
|
Service Code
|
APR-DRG 1823
|
| Min. Negotiated Rate |
$16,324.17 |
| Max. Negotiated Rate |
$17,140.38 |
| Rate for Payer: BCBS Complete |
$17,140.38
|
| Rate for Payer: Mclaren Medicaid |
$16,324.17
|
| Rate for Payer: Meridian Medicaid |
$17,140.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,324.17
|
| Rate for Payer: UHC Medicaid |
$16,324.17
|
| Rate for Payer: UHCCP Medicaid |
$16,324.17
|
|
|
OTHER UPPER VASCULAR PROCEDURES
|
Facility
|
IP
|
$11,544.15
|
|
|
Service Code
|
APR-DRG 1821
|
| Min. Negotiated Rate |
$10,994.43 |
| Max. Negotiated Rate |
$11,544.15 |
| Rate for Payer: BCBS Complete |
$11,544.15
|
| Rate for Payer: Mclaren Medicaid |
$10,994.43
|
| Rate for Payer: Meridian Medicaid |
$11,544.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,994.43
|
| Rate for Payer: UHC Medicaid |
$10,994.43
|
| Rate for Payer: UHCCP Medicaid |
$10,994.43
|
|
|
OTHER UPPER VASCULAR PROCEDURES
|
Facility
|
IP
|
$14,047.78
|
|
|
Service Code
|
APR-DRG 1822
|
| Min. Negotiated Rate |
$13,378.84 |
| Max. Negotiated Rate |
$14,047.78 |
| Rate for Payer: BCBS Complete |
$14,047.78
|
| Rate for Payer: Mclaren Medicaid |
$13,378.84
|
| Rate for Payer: Meridian Medicaid |
$14,047.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,378.84
|
| Rate for Payer: UHC Medicaid |
$13,378.84
|
| Rate for Payer: UHCCP Medicaid |
$13,378.84
|
|
|
OTHER UPPER VASCULAR PROCEDURES
|
Facility
|
IP
|
$27,383.09
|
|
|
Service Code
|
APR-DRG 1824
|
| Min. Negotiated Rate |
$26,079.13 |
| Max. Negotiated Rate |
$27,383.09 |
| Rate for Payer: BCBS Complete |
$27,383.09
|
| Rate for Payer: Mclaren Medicaid |
$26,079.13
|
| Rate for Payer: Meridian Medicaid |
$27,383.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,079.13
|
| Rate for Payer: UHC Medicaid |
$26,079.13
|
| Rate for Payer: UHCCP Medicaid |
$26,079.13
|
|
|
OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$56,642.39
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$21,184.22 |
| Max. Negotiated Rate |
$56,642.39 |
| Rate for Payer: Aetna Medicare |
$23,191.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,873.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,873.97
|
| Rate for Payer: BCBS MAPPO |
$22,299.18
|
| Rate for Payer: BCBS Trust/PPO |
$56,642.39
|
| Rate for Payer: BCN Commercial |
$56,642.39
|
| Rate for Payer: BCN Medicare Advantage |
$22,299.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,299.18
|
| Rate for Payer: Mclaren Medicare |
$22,299.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,414.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,644.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,529.10
|
| Rate for Payer: Nomi Health Commercial |
$33,483.24
|
| Rate for Payer: PACE Medicare |
$21,184.22
|
| Rate for Payer: PACE SWMI |
$22,299.18
|
| Rate for Payer: PHP Medicare Advantage |
$22,299.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,846.63
|
| Rate for Payer: Priority Health Medicare |
$22,299.18
|
| Rate for Payer: Priority Health Tiered Network |
$33,477.30
|
| Rate for Payer: Railroad Medicare Medicare |
$22,299.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42,308.28
|
| Rate for Payer: UHC Core |
$35,396.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,299.18
|
| Rate for Payer: UHC Exchange |
$28,907.20
|
| Rate for Payer: VA VA |
$22,299.18
|
|
|
OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$103,525.96
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$28,276.31 |
| Max. Negotiated Rate |
$103,525.96 |
| Rate for Payer: Aetna Medicare |
$30,955.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,205.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,205.68
|
| Rate for Payer: BCBS MAPPO |
$29,764.54
|
| Rate for Payer: BCBS Trust/PPO |
$103,525.96
|
| Rate for Payer: BCN Commercial |
$103,525.96
|
| Rate for Payer: BCN Medicare Advantage |
$29,764.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,764.54
|
| Rate for Payer: Mclaren Medicare |
$29,764.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,252.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,229.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$32,740.99
|
| Rate for Payer: Nomi Health Commercial |
$44,999.07
|
| Rate for Payer: PACE Medicare |
$28,276.31
|
| Rate for Payer: PACE SWMI |
$29,764.54
|
| Rate for Payer: PHP Medicare Advantage |
$29,764.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56,238.86
|
| Rate for Payer: Priority Health Medicare |
$29,764.54
|
| Rate for Payer: Priority Health Tiered Network |
$44,991.08
|
| Rate for Payer: Railroad Medicare Medicare |
$29,764.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,859.29
|
| Rate for Payer: UHC Core |
$47,569.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29,764.54
|
| Rate for Payer: UHC Exchange |
$38,849.20
|
| Rate for Payer: VA VA |
$29,764.54
|
|
|
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,901.99
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$14,718.15 |
| Max. Negotiated Rate |
$40,901.99 |
| Rate for Payer: Aetna Medicare |
$16,112.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,365.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,365.99
|
| Rate for Payer: BCBS MAPPO |
$15,492.79
|
| Rate for Payer: BCBS Trust/PPO |
$40,901.99
|
| Rate for Payer: BCN Commercial |
$40,901.99
|
| Rate for Payer: BCN Medicare Advantage |
$15,492.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,492.79
|
| Rate for Payer: Mclaren Medicare |
$15,492.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,267.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,816.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,042.07
|
| Rate for Payer: Nomi Health Commercial |
$22,983.93
|
| Rate for Payer: PACE Medicare |
$14,718.15
|
| Rate for Payer: PACE SWMI |
$15,492.79
|
| Rate for Payer: PHP Medicare Advantage |
$15,492.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,724.82
|
| Rate for Payer: Priority Health Medicare |
$15,492.79
|
| Rate for Payer: Priority Health Tiered Network |
$22,979.85
|
| Rate for Payer: Railroad Medicare Medicare |
$15,492.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,041.71
|
| Rate for Payer: UHC Core |
$24,297.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,492.79
|
| Rate for Payer: UHC Exchange |
$19,842.79
|
| Rate for Payer: VA VA |
$15,492.79
|
|
|
OTITIS MEDIA AND URI WITH MCC
|
Facility
|
IP
|
$19,269.86
|
|
|
Service Code
|
MSDRG 152
|
| Min. Negotiated Rate |
$9,955.37 |
| Max. Negotiated Rate |
$19,269.86 |
| Rate for Payer: Aetna Medicare |
$10,898.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,099.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,099.17
|
| Rate for Payer: BCBS MAPPO |
$10,479.34
|
| Rate for Payer: BCBS Trust/PPO |
$14,175.70
|
| Rate for Payer: BCN Commercial |
$14,175.70
|
| Rate for Payer: BCN Medicare Advantage |
$10,479.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,479.34
|
| Rate for Payer: Mclaren Medicare |
$10,479.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,003.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,051.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,527.27
|
| Rate for Payer: Nomi Health Commercial |
$15,250.38
|
| Rate for Payer: PACE Medicare |
$9,955.37
|
| Rate for Payer: PACE SWMI |
$10,479.34
|
| Rate for Payer: PHP Medicare Advantage |
$10,479.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,059.59
|
| Rate for Payer: Priority Health Medicare |
$10,479.34
|
| Rate for Payer: Priority Health Tiered Network |
$15,247.67
|
| Rate for Payer: Railroad Medicare Medicare |
$10,479.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,269.86
|
| Rate for Payer: UHC Core |
$16,121.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,479.34
|
| Rate for Payer: UHC Exchange |
$13,166.16
|
| Rate for Payer: VA VA |
$10,479.34
|
|
|
OTITIS MEDIA AND URI WITHOUT MCC
|
Facility
|
IP
|
$12,032.66
|
|
|
Service Code
|
MSDRG 153
|
| Min. Negotiated Rate |
$6,428.00 |
| Max. Negotiated Rate |
$12,032.66 |
| Rate for Payer: Aetna Medicare |
$7,036.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,457.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,457.90
|
| Rate for Payer: BCBS MAPPO |
$6,766.32
|
| Rate for Payer: BCBS Trust/PPO |
$9,810.99
|
| Rate for Payer: BCN Commercial |
$9,810.99
|
| Rate for Payer: BCN Medicare Advantage |
$6,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,766.32
|
| Rate for Payer: Mclaren Medicare |
$6,766.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,104.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,781.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,442.95
|
| Rate for Payer: Nomi Health Commercial |
$9,522.78
|
| Rate for Payer: PACE Medicare |
$6,428.00
|
| Rate for Payer: PACE SWMI |
$6,766.32
|
| Rate for Payer: PHP Medicare Advantage |
$6,766.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,901.36
|
| Rate for Payer: Priority Health Medicare |
$6,766.32
|
| Rate for Payer: Priority Health Tiered Network |
$9,521.09
|
| Rate for Payer: Railroad Medicare Medicare |
$6,766.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,032.66
|
| Rate for Payer: UHC Core |
$10,066.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,766.32
|
| Rate for Payer: UHC Exchange |
$8,221.33
|
| Rate for Payer: VA VA |
$6,766.32
|
|
|
OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL
|
Facility
|
OP
|
$16,119.31
|
|
|
Service Code
|
CPT 58925
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,299.96
|
| Rate for Payer: BCN Commercial |
$4,299.96
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: VA VA |
$4,984.46
|
|
|
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$516.15
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
99612
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$227.11 |
| Max. Negotiated Rate |
$464.54 |
| Rate for Payer: Aetna American Axle |
$335.50
|
| Rate for Payer: Aetna American Axle |
$185.48
|
| Rate for Payer: Aetna American Axle |
$182.02
|
| Rate for Payer: Aetna American Axle |
$110.06
|
| Rate for Payer: Aetna American Axle |
$150.57
|
| Rate for Payer: Aetna American Axle |
$149.51
|
| Rate for Payer: Aetna Commercial |
$438.73
|
| Rate for Payer: Aetna Commercial |
$196.90
|
| Rate for Payer: Aetna Commercial |
$238.03
|
| Rate for Payer: Aetna Commercial |
$195.51
|
| Rate for Payer: Aetna Commercial |
$242.56
|
| Rate for Payer: Aetna Commercial |
$143.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.06
|
| Rate for Payer: Cash Price |
$412.92
|
| Rate for Payer: Cash Price |
$228.29
|
| Rate for Payer: Cash Price |
$224.02
|
| Rate for Payer: Cash Price |
$135.46
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cash Price |
$184.01
|
| Rate for Payer: Cofinity Advantage |
$196.02
|
| Rate for Payer: Cofinity Advantage |
$161.01
|
| Rate for Payer: Cofinity Advantage |
$118.53
|
| Rate for Payer: Cofinity Advantage |
$199.75
|
| Rate for Payer: Cofinity Advantage |
$162.16
|
| Rate for Payer: Cofinity Advantage |
$361.31
|
| Rate for Payer: Cofinity Commercial |
$197.81
|
| Rate for Payer: Cofinity Commercial |
$240.83
|
| Rate for Payer: Cofinity Commercial |
$245.41
|
| Rate for Payer: Cofinity Commercial |
$145.62
|
| Rate for Payer: Cofinity Commercial |
$199.22
|
| Rate for Payer: Cofinity Commercial |
$443.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.92
|
| Rate for Payer: Healthscope Commercial |
$256.82
|
| Rate for Payer: Healthscope Commercial |
$152.40
|
| Rate for Payer: Healthscope Commercial |
$252.03
|
| Rate for Payer: Healthscope Commercial |
$207.01
|
| Rate for Payer: Healthscope Commercial |
$208.49
|
| Rate for Payer: Healthscope Commercial |
$464.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.74
|
| Rate for Payer: PHP Commercial |
$196.90
|
| Rate for Payer: PHP Commercial |
$438.73
|
| Rate for Payer: PHP Commercial |
$242.56
|
| Rate for Payer: PHP Commercial |
$238.03
|
| Rate for Payer: PHP Commercial |
$143.93
|
| Rate for Payer: PHP Commercial |
$195.51
|
| Rate for Payer: Priority Health SBD |
$179.78
|
| Rate for Payer: Priority Health SBD |
$144.91
|
| Rate for Payer: Priority Health SBD |
$106.68
|
| Rate for Payer: Priority Health SBD |
$145.94
|
| Rate for Payer: Priority Health SBD |
$176.42
|
| Rate for Payer: Priority Health SBD |
$325.17
|
| Rate for Payer: UMR Bronson Commercial |
$125.56
|
| Rate for Payer: UMR Bronson Commercial |
$101.93
|
| Rate for Payer: UMR Bronson Commercial |
$123.21
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
| Rate for Payer: UMR Bronson Commercial |
$227.11
|
| Rate for Payer: UMR Bronson Commercial |
$74.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.74
|
|
|
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$230.01
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
99612
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$207.01 |
| Rate for Payer: Aetna American Axle |
$149.51
|
| Rate for Payer: Aetna American Axle |
$179.76
|
| Rate for Payer: Aetna American Axle |
$182.02
|
| Rate for Payer: Aetna American Axle |
$168.96
|
| Rate for Payer: Aetna American Axle |
$185.48
|
| Rate for Payer: Aetna American Axle |
$159.57
|
| Rate for Payer: Aetna American Axle |
$278.90
|
| Rate for Payer: Aetna American Axle |
$335.50
|
| Rate for Payer: Aetna American Axle |
$110.06
|
| Rate for Payer: Aetna American Axle |
$586.22
|
| Rate for Payer: Aetna American Axle |
$150.57
|
| Rate for Payer: Aetna Commercial |
$143.93
|
| Rate for Payer: Aetna Commercial |
$766.60
|
| Rate for Payer: Aetna Commercial |
$438.73
|
| Rate for Payer: Aetna Commercial |
$195.51
|
| Rate for Payer: Aetna Commercial |
$364.71
|
| Rate for Payer: Aetna Commercial |
$208.68
|
| Rate for Payer: Aetna Commercial |
$196.90
|
| Rate for Payer: Aetna Commercial |
$242.56
|
| Rate for Payer: Aetna Commercial |
$220.95
|
| Rate for Payer: Aetna Commercial |
$235.07
|
| Rate for Payer: Aetna Commercial |
$238.03
|
| Rate for Payer: Aetna Medicare |
$450.94
|
| Rate for Payer: Aetna Medicare |
$115.83
|
| Rate for Payer: Aetna Medicare |
$84.67
|
| Rate for Payer: Aetna Medicare |
$122.75
|
| Rate for Payer: Aetna Medicare |
$115.00
|
| Rate for Payer: Aetna Medicare |
$214.53
|
| Rate for Payer: Aetna Medicare |
$258.07
|
| Rate for Payer: Aetna Medicare |
$142.68
|
| Rate for Payer: Aetna Medicare |
$138.28
|
| Rate for Payer: Aetna Medicare |
$140.01
|
| Rate for Payer: Aetna Medicare |
$129.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.22
|
| Rate for Payer: BCBS Complete |
$110.62
|
| Rate for Payer: BCBS Complete |
$98.20
|
| Rate for Payer: BCBS Complete |
$67.73
|
| Rate for Payer: BCBS Complete |
$114.14
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Complete |
$112.01
|
| Rate for Payer: BCBS Complete |
$103.98
|
| Rate for Payer: BCBS Complete |
$206.46
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: BCBS Complete |
$171.63
|
| Rate for Payer: BCBS Complete |
$92.66
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$135.46
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cash Price |
$184.01
|
| Rate for Payer: Cash Price |
$184.01
|
| Rate for Payer: Cash Price |
$721.50
|
| Rate for Payer: Cash Price |
$721.50
|
| Rate for Payer: Cash Price |
$412.92
|
| Rate for Payer: Cash Price |
$224.02
|
| Rate for Payer: Cash Price |
$412.92
|
| Rate for Payer: Cash Price |
$343.26
|
| Rate for Payer: Cash Price |
$343.26
|
| Rate for Payer: Cash Price |
$196.40
|
| Rate for Payer: Cash Price |
$196.40
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$228.29
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$228.29
|
| Rate for Payer: Cash Price |
$207.95
|
| Rate for Payer: Cash Price |
$207.95
|
| Rate for Payer: Cash Price |
$224.02
|
| Rate for Payer: Cash Price |
$135.46
|
| Rate for Payer: Cofinity Advantage |
$300.35
|
| Rate for Payer: Cofinity Advantage |
$161.01
|
| Rate for Payer: Cofinity Advantage |
$181.96
|
| Rate for Payer: Cofinity Advantage |
$171.85
|
| Rate for Payer: Cofinity Advantage |
$162.16
|
| Rate for Payer: Cofinity Advantage |
$193.59
|
| Rate for Payer: Cofinity Advantage |
$196.02
|
| Rate for Payer: Cofinity Advantage |
$118.53
|
| Rate for Payer: Cofinity Advantage |
$199.75
|
| Rate for Payer: Cofinity Advantage |
$631.32
|
| Rate for Payer: Cofinity Advantage |
$361.31
|
| Rate for Payer: Cofinity Commercial |
$145.62
|
| Rate for Payer: Cofinity Commercial |
$245.41
|
| Rate for Payer: Cofinity Commercial |
$240.83
|
| Rate for Payer: Cofinity Commercial |
$369.00
|
| Rate for Payer: Cofinity Commercial |
$443.89
|
| Rate for Payer: Cofinity Commercial |
$223.55
|
| Rate for Payer: Cofinity Commercial |
$237.83
|
| Rate for Payer: Cofinity Commercial |
$775.62
|
| Rate for Payer: Cofinity Commercial |
$199.22
|
| Rate for Payer: Cofinity Commercial |
$211.13
|
| Rate for Payer: Cofinity Commercial |
$197.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.29
|
| Rate for Payer: Healthscope Commercial |
$464.54
|
| Rate for Payer: Healthscope Commercial |
$207.01
|
| Rate for Payer: Healthscope Commercial |
$152.40
|
| Rate for Payer: Healthscope Commercial |
$208.49
|
| Rate for Payer: Healthscope Commercial |
$220.95
|
| Rate for Payer: Healthscope Commercial |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$248.90
|
| Rate for Payer: Healthscope Commercial |
$252.03
|
| Rate for Payer: Healthscope Commercial |
$256.82
|
| Rate for Payer: Healthscope Commercial |
$386.16
|
| Rate for Payer: Healthscope Commercial |
$811.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$224.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.74
|
| Rate for Payer: PHP Commercial |
$235.07
|
| Rate for Payer: PHP Commercial |
$242.56
|
| Rate for Payer: PHP Commercial |
$238.03
|
| Rate for Payer: PHP Commercial |
$208.68
|
| Rate for Payer: PHP Commercial |
$438.73
|
| Rate for Payer: PHP Commercial |
$195.51
|
| Rate for Payer: PHP Commercial |
$364.71
|
| Rate for Payer: PHP Commercial |
$766.60
|
| Rate for Payer: PHP Commercial |
$220.95
|
| Rate for Payer: PHP Commercial |
$143.93
|
| Rate for Payer: PHP Commercial |
$196.90
|
| Rate for Payer: Priority Health SBD |
$144.91
|
| Rate for Payer: Priority Health SBD |
$270.31
|
| Rate for Payer: Priority Health SBD |
$106.68
|
| Rate for Payer: Priority Health SBD |
$174.23
|
| Rate for Payer: Priority Health SBD |
$154.66
|
| Rate for Payer: Priority Health SBD |
$179.78
|
| Rate for Payer: Priority Health SBD |
$568.18
|
| Rate for Payer: Priority Health SBD |
$145.94
|
| Rate for Payer: Priority Health SBD |
$325.17
|
| Rate for Payer: Priority Health SBD |
$176.42
|
| Rate for Payer: Priority Health SBD |
$163.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UMR Bronson Commercial |
$62.65
|
| Rate for Payer: UMR Bronson Commercial |
$158.76
|
| Rate for Payer: UMR Bronson Commercial |
$333.70
|
| Rate for Payer: UMR Bronson Commercial |
$103.61
|
| Rate for Payer: UMR Bronson Commercial |
$190.98
|
| Rate for Payer: UMR Bronson Commercial |
$85.71
|
| Rate for Payer: UMR Bronson Commercial |
$105.58
|
| Rate for Payer: UMR Bronson Commercial |
$96.18
|
| Rate for Payer: UMR Bronson Commercial |
$90.83
|
| Rate for Payer: UMR Bronson Commercial |
$102.32
|
| Rate for Payer: UMR Bronson Commercial |
$85.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.96
|
|
|
OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$119.72
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
41598
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna American Axle |
$77.82
|
| Rate for Payer: Aetna American Axle |
$185.89
|
| Rate for Payer: Aetna American Axle |
$89.18
|
| Rate for Payer: Aetna American Axle |
$136.32
|
| Rate for Payer: Aetna American Axle |
$173.49
|
| Rate for Payer: Aetna American Axle |
$89.81
|
| Rate for Payer: Aetna American Axle |
$88.61
|
| Rate for Payer: Aetna Commercial |
$243.08
|
| Rate for Payer: Aetna Commercial |
$116.62
|
| Rate for Payer: Aetna Commercial |
$178.26
|
| Rate for Payer: Aetna Commercial |
$115.88
|
| Rate for Payer: Aetna Commercial |
$101.76
|
| Rate for Payer: Aetna Commercial |
$117.44
|
| Rate for Payer: Aetna Commercial |
$226.87
|
| Rate for Payer: Aetna Medicare |
$133.46
|
| Rate for Payer: Aetna Medicare |
$69.08
|
| Rate for Payer: Aetna Medicare |
$68.60
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: Aetna Medicare |
$104.86
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Aetna Medicare |
$142.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.89
|
| Rate for Payer: BCBS Complete |
$114.39
|
| Rate for Payer: BCBS Complete |
$54.88
|
| Rate for Payer: BCBS Complete |
$55.27
|
| Rate for Payer: BCBS Complete |
$83.89
|
| Rate for Payer: BCBS Complete |
$54.53
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS Complete |
$106.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$167.78
|
| Rate for Payer: Cash Price |
$228.78
|
| Rate for Payer: Cash Price |
$109.76
|
| Rate for Payer: Cash Price |
$110.54
|
| Rate for Payer: Cash Price |
$109.06
|
| Rate for Payer: Cash Price |
$95.78
|
| Rate for Payer: Cash Price |
$95.78
|
| Rate for Payer: Cash Price |
$167.78
|
| Rate for Payer: Cash Price |
$109.06
|
| Rate for Payer: Cash Price |
$109.76
|
| Rate for Payer: Cash Price |
$110.54
|
| Rate for Payer: Cash Price |
$213.53
|
| Rate for Payer: Cash Price |
$213.53
|
| Rate for Payer: Cash Price |
$228.78
|
| Rate for Payer: Cofinity Advantage |
$146.80
|
| Rate for Payer: Cofinity Advantage |
$186.84
|
| Rate for Payer: Cofinity Advantage |
$96.04
|
| Rate for Payer: Cofinity Advantage |
$83.80
|
| Rate for Payer: Cofinity Advantage |
$200.19
|
| Rate for Payer: Cofinity Advantage |
$96.72
|
| Rate for Payer: Cofinity Advantage |
$95.43
|
| Rate for Payer: Cofinity Commercial |
$117.24
|
| Rate for Payer: Cofinity Commercial |
$102.96
|
| Rate for Payer: Cofinity Commercial |
$117.99
|
| Rate for Payer: Cofinity Commercial |
$118.83
|
| Rate for Payer: Cofinity Commercial |
$180.36
|
| Rate for Payer: Cofinity Commercial |
$229.54
|
| Rate for Payer: Cofinity Commercial |
$245.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.06
|
| Rate for Payer: Healthscope Commercial |
$124.35
|
| Rate for Payer: Healthscope Commercial |
$188.75
|
| Rate for Payer: Healthscope Commercial |
$107.75
|
| Rate for Payer: Healthscope Commercial |
$123.48
|
| Rate for Payer: Healthscope Commercial |
$240.22
|
| Rate for Payer: Healthscope Commercial |
$257.38
|
| Rate for Payer: Healthscope Commercial |
$122.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PHP Commercial |
$226.87
|
| Rate for Payer: PHP Commercial |
$116.62
|
| Rate for Payer: PHP Commercial |
$115.88
|
| Rate for Payer: PHP Commercial |
$101.76
|
| Rate for Payer: PHP Commercial |
$243.08
|
| Rate for Payer: PHP Commercial |
$117.44
|
| Rate for Payer: PHP Commercial |
$178.26
|
| Rate for Payer: Priority Health SBD |
$168.15
|
| Rate for Payer: Priority Health SBD |
$86.44
|
| Rate for Payer: Priority Health SBD |
$75.42
|
| Rate for Payer: Priority Health SBD |
$132.12
|
| Rate for Payer: Priority Health SBD |
$180.17
|
| Rate for Payer: Priority Health SBD |
$85.89
|
| Rate for Payer: Priority Health SBD |
$87.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UMR Bronson Commercial |
$105.81
|
| Rate for Payer: UMR Bronson Commercial |
$98.76
|
| Rate for Payer: UMR Bronson Commercial |
$50.44
|
| Rate for Payer: UMR Bronson Commercial |
$50.76
|
| Rate for Payer: UMR Bronson Commercial |
$77.60
|
| Rate for Payer: UMR Bronson Commercial |
$44.30
|
| Rate for Payer: UMR Bronson Commercial |
$51.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.25
|
|
|
OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$285.98
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
41598
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.83 |
| Max. Negotiated Rate |
$257.38 |
| Rate for Payer: Aetna American Axle |
$185.89
|
| Rate for Payer: Aetna Commercial |
$243.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.89
|
| Rate for Payer: Cash Price |
$228.78
|
| Rate for Payer: Cofinity Advantage |
$200.19
|
| Rate for Payer: Cofinity Commercial |
$245.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.78
|
| Rate for Payer: Healthscope Commercial |
$257.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PHP Commercial |
$243.08
|
| Rate for Payer: Priority Health SBD |
$180.17
|
| Rate for Payer: UMR Bronson Commercial |
$125.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$980.87
|
|
|
Service Code
|
NDC 62584081301
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$431.58 |
| Max. Negotiated Rate |
$882.78 |
| Rate for Payer: Aetna American Axle |
$637.57
|
| Rate for Payer: Aetna Commercial |
$833.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.57
|
| Rate for Payer: Cash Price |
$784.70
|
| Rate for Payer: Cofinity Advantage |
$686.61
|
| Rate for Payer: Cofinity Commercial |
$843.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.70
|
| Rate for Payer: Healthscope Commercial |
$882.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$686.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.65
|
| Rate for Payer: PHP Commercial |
$833.74
|
| Rate for Payer: Priority Health SBD |
$617.95
|
| Rate for Payer: UMR Bronson Commercial |
$431.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.65
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$540.96
|
|
|
Service Code
|
NDC 00228206910
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$238.02 |
| Max. Negotiated Rate |
$486.86 |
| Rate for Payer: Aetna American Axle |
$351.62
|
| Rate for Payer: Aetna Commercial |
$459.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.62
|
| Rate for Payer: Cash Price |
$432.77
|
| Rate for Payer: Cofinity Advantage |
$378.67
|
| Rate for Payer: Cofinity Commercial |
$465.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.77
|
| Rate for Payer: Healthscope Commercial |
$486.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.72
|
| Rate for Payer: PHP Commercial |
$459.82
|
| Rate for Payer: Priority Health SBD |
$340.80
|
| Rate for Payer: UMR Bronson Commercial |
$238.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.72
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$9.81
|
|
|
Service Code
|
NDC 62584081311
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: Aetna American Axle |
$6.38
|
| Rate for Payer: Aetna Commercial |
$8.34
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.92
|
| Rate for Payer: Cash Price |
$7.85
|
| Rate for Payer: Cofinity Advantage |
$6.87
|
| Rate for Payer: Cofinity Commercial |
$8.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.36
|
| Rate for Payer: PHP Commercial |
$8.34
|
| Rate for Payer: Priority Health SBD |
$6.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.38
|
| Rate for Payer: UHC Core |
$5.11
|
| Rate for Payer: UHC Exchange |
$3.86
|
| Rate for Payer: UMR Bronson Commercial |
$3.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.36
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$9.81
|
|
|
Service Code
|
NDC 62584081311
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$8.83 |
| Rate for Payer: Aetna American Axle |
$6.38
|
| Rate for Payer: Aetna Commercial |
$8.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.38
|
| Rate for Payer: Cash Price |
$7.85
|
| Rate for Payer: Cofinity Advantage |
$6.87
|
| Rate for Payer: Cofinity Commercial |
$8.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.36
|
| Rate for Payer: PHP Commercial |
$8.34
|
| Rate for Payer: Priority Health SBD |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$4.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.36
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$980.87
|
|
|
Service Code
|
NDC 62584081301
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$362.92 |
| Max. Negotiated Rate |
$882.78 |
| Rate for Payer: Aetna American Axle |
$637.57
|
| Rate for Payer: Aetna Commercial |
$833.74
|
| Rate for Payer: Aetna Medicare |
$490.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.57
|
| Rate for Payer: BCBS Complete |
$392.35
|
| Rate for Payer: Cash Price |
$784.70
|
| Rate for Payer: Cofinity Advantage |
$686.61
|
| Rate for Payer: Cofinity Commercial |
$843.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.70
|
| Rate for Payer: Healthscope Commercial |
$882.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$686.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.65
|
| Rate for Payer: PHP Commercial |
$833.74
|
| Rate for Payer: Priority Health SBD |
$617.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.57
|
| Rate for Payer: UHC Core |
$511.03
|
| Rate for Payer: UHC Exchange |
$385.48
|
| Rate for Payer: UMR Bronson Commercial |
$362.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.65
|
|
|
OXAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$540.96
|
|
|
Service Code
|
NDC 00228206910
|
| Hospital Charge Code |
5931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$200.16 |
| Max. Negotiated Rate |
$486.86 |
| Rate for Payer: Aetna American Axle |
$351.62
|
| Rate for Payer: Aetna Commercial |
$459.82
|
| Rate for Payer: Aetna Medicare |
$270.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.62
|
| Rate for Payer: BCBS Complete |
$216.38
|
| Rate for Payer: Cash Price |
$432.77
|
| Rate for Payer: Cofinity Advantage |
$378.67
|
| Rate for Payer: Cofinity Commercial |
$465.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.77
|
| Rate for Payer: Healthscope Commercial |
$486.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$432.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.72
|
| Rate for Payer: PHP Commercial |
$459.82
|
| Rate for Payer: Priority Health SBD |
$340.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.62
|
| Rate for Payer: UHC Core |
$281.84
|
| Rate for Payer: UHC Exchange |
$212.60
|
| Rate for Payer: UMR Bronson Commercial |
$200.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.72
|
|
