|
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET
|
Facility
|
IP
|
$238.45
|
|
|
Service Code
|
NDC 68084009411
|
| Hospital Charge Code |
9408
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.92 |
| Max. Negotiated Rate |
$214.60 |
| Rate for Payer: Aetna American Axle |
$154.99
|
| Rate for Payer: Aetna Commercial |
$202.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.99
|
| Rate for Payer: Cash Price |
$190.76
|
| Rate for Payer: Cofinity Advantage |
$166.91
|
| Rate for Payer: Cofinity Commercial |
$205.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.76
|
| Rate for Payer: Healthscope Commercial |
$214.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.84
|
| Rate for Payer: PHP Commercial |
$202.68
|
| Rate for Payer: Priority Health SBD |
$150.22
|
| Rate for Payer: UMR Bronson Commercial |
$104.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.84
|
|
|
CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET
|
Facility
|
OP
|
$322.05
|
|
|
Service Code
|
NDC 00904754961
|
| Hospital Charge Code |
9408
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.16 |
| Max. Negotiated Rate |
$289.85 |
| Rate for Payer: Aetna American Axle |
$209.33
|
| Rate for Payer: Aetna Commercial |
$273.74
|
| Rate for Payer: Aetna Medicare |
$161.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.33
|
| Rate for Payer: BCBS Complete |
$128.82
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Advantage |
$225.44
|
| Rate for Payer: Cofinity Commercial |
$276.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.64
|
| Rate for Payer: Healthscope Commercial |
$289.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$257.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.54
|
| Rate for Payer: PHP Commercial |
$273.74
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.33
|
| Rate for Payer: UHC Core |
$167.79
|
| Rate for Payer: UHC Exchange |
$126.57
|
| Rate for Payer: UMR Bronson Commercial |
$119.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.54
|
|
|
CARBIDOPA 4.63 MG-LEVODOPA 20 MG/ML SUSPENSION IN J-TUBE PUMP
|
Facility
|
IP
|
$807.71
|
|
|
Service Code
|
HCPCS J7340
|
| Hospital Charge Code |
174006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$355.39 |
| Max. Negotiated Rate |
$726.94 |
| Rate for Payer: Aetna American Axle |
$525.01
|
| Rate for Payer: Aetna Commercial |
$686.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.01
|
| Rate for Payer: Cash Price |
$646.17
|
| Rate for Payer: Cofinity Advantage |
$565.40
|
| Rate for Payer: Cofinity Commercial |
$694.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.17
|
| Rate for Payer: Healthscope Commercial |
$726.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$565.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$605.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$686.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$605.78
|
| Rate for Payer: PHP Commercial |
$686.55
|
| Rate for Payer: Priority Health SBD |
$508.86
|
| Rate for Payer: UMR Bronson Commercial |
$355.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$605.78
|
|
|
CARBIDOPA 4.63 MG-LEVODOPA 20 MG/ML SUSPENSION IN J-TUBE PUMP
|
Facility
|
OP
|
$807.71
|
|
|
Service Code
|
HCPCS J7340
|
| Hospital Charge Code |
174006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.63 |
| Max. Negotiated Rate |
$790.49 |
| Rate for Payer: Aetna American Axle |
$525.01
|
| Rate for Payer: Aetna Commercial |
$686.55
|
| Rate for Payer: Aetna Medicare |
$253.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.05
|
| Rate for Payer: BCBS Complete |
$134.03
|
| Rate for Payer: BCBS MAPPO |
$244.04
|
| Rate for Payer: BCBS Trust/PPO |
$790.49
|
| Rate for Payer: BCN Commercial |
$790.49
|
| Rate for Payer: BCN Medicare Advantage |
$244.04
|
| Rate for Payer: Cash Price |
$646.17
|
| Rate for Payer: Cash Price |
$646.17
|
| Rate for Payer: Cofinity Advantage |
$565.40
|
| Rate for Payer: Cofinity Commercial |
$694.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.04
|
| Rate for Payer: Healthscope Commercial |
$726.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$565.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$605.78
|
| Rate for Payer: Mclaren Medicaid |
$244.04
|
| Rate for Payer: Mclaren Medicare |
$244.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.24
|
| Rate for Payer: Meridian Medicaid |
$256.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$268.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$686.55
|
| Rate for Payer: Nomi Health Commercial |
$732.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$605.78
|
| Rate for Payer: PACE Medicare |
$231.84
|
| Rate for Payer: PACE SWMI |
$244.04
|
| Rate for Payer: PHP Commercial |
$686.55
|
| Rate for Payer: PHP Medicare Advantage |
$244.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.32
|
| Rate for Payer: Priority Health Medicare |
$244.04
|
| Rate for Payer: Priority Health SBD |
$508.86
|
| Rate for Payer: Priority Health Tiered Network |
$614.66
|
| Rate for Payer: Railroad Medicare Medicare |
$244.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.25
|
| Rate for Payer: UHC Core |
$402.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$244.04
|
| Rate for Payer: UHC Exchange |
$402.25
|
| Rate for Payer: UHC Medicaid |
$127.63
|
| Rate for Payer: UHCCP Medicaid |
$127.63
|
| Rate for Payer: UMR Bronson Commercial |
$298.85
|
| Rate for Payer: VA VA |
$244.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$605.78
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$318.25
|
|
|
Service Code
|
NDC 51079097820
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.03 |
| Max. Negotiated Rate |
$286.43 |
| Rate for Payer: Aetna American Axle |
$206.86
|
| Rate for Payer: Aetna Commercial |
$270.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.86
|
| Rate for Payer: Cash Price |
$254.60
|
| Rate for Payer: Cofinity Advantage |
$222.78
|
| Rate for Payer: Cofinity Commercial |
$273.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.60
|
| Rate for Payer: Healthscope Commercial |
$286.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.69
|
| Rate for Payer: PHP Commercial |
$270.51
|
| Rate for Payer: Priority Health SBD |
$200.50
|
| Rate for Payer: UMR Bronson Commercial |
$140.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.69
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$331.55
|
|
|
Service Code
|
NDC 62756046188
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.88 |
| Max. Negotiated Rate |
$298.39 |
| Rate for Payer: Aetna American Axle |
$215.51
|
| Rate for Payer: Aetna Commercial |
$281.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.51
|
| Rate for Payer: Cash Price |
$265.24
|
| Rate for Payer: Cofinity Advantage |
$232.09
|
| Rate for Payer: Cofinity Commercial |
$285.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.24
|
| Rate for Payer: Healthscope Commercial |
$298.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.66
|
| Rate for Payer: PHP Commercial |
$281.82
|
| Rate for Payer: Priority Health SBD |
$208.88
|
| Rate for Payer: UMR Bronson Commercial |
$145.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.66
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$3.28
|
|
|
Service Code
|
NDC 68084028111
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$2.95 |
| Rate for Payer: Aetna American Axle |
$2.13
|
| Rate for Payer: Aetna Commercial |
$2.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.13
|
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Cofinity Advantage |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.62
|
| Rate for Payer: Healthscope Commercial |
$2.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.46
|
| Rate for Payer: PHP Commercial |
$2.79
|
| Rate for Payer: Priority Health SBD |
$2.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.46
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$3.19
|
|
|
Service Code
|
NDC 51079097801
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$2.87 |
| Rate for Payer: Aetna American Axle |
$2.07
|
| Rate for Payer: Aetna Commercial |
$2.71
|
| Rate for Payer: Aetna Medicare |
$1.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.07
|
| Rate for Payer: BCBS Complete |
$1.28
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cofinity Advantage |
$2.23
|
| Rate for Payer: Cofinity Commercial |
$2.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.55
|
| Rate for Payer: Healthscope Commercial |
$2.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.39
|
| Rate for Payer: PHP Commercial |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.07
|
| Rate for Payer: UHC Core |
$1.66
|
| Rate for Payer: UHC Exchange |
$1.25
|
| Rate for Payer: UMR Bronson Commercial |
$1.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.39
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$3.19
|
|
|
Service Code
|
NDC 51079097801
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$2.87 |
| Rate for Payer: Aetna American Axle |
$2.07
|
| Rate for Payer: Aetna Commercial |
$2.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.07
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cofinity Advantage |
$2.23
|
| Rate for Payer: Cofinity Commercial |
$2.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.55
|
| Rate for Payer: Healthscope Commercial |
$2.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.39
|
| Rate for Payer: PHP Commercial |
$2.71
|
| Rate for Payer: Priority Health SBD |
$2.01
|
| Rate for Payer: UMR Bronson Commercial |
$1.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.39
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$318.25
|
|
|
Service Code
|
NDC 51079097820
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.75 |
| Max. Negotiated Rate |
$286.43 |
| Rate for Payer: Aetna American Axle |
$206.86
|
| Rate for Payer: Aetna Commercial |
$270.51
|
| Rate for Payer: Aetna Medicare |
$159.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.86
|
| Rate for Payer: BCBS Complete |
$127.30
|
| Rate for Payer: Cash Price |
$254.60
|
| Rate for Payer: Cofinity Advantage |
$222.78
|
| Rate for Payer: Cofinity Commercial |
$273.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.60
|
| Rate for Payer: Healthscope Commercial |
$286.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.69
|
| Rate for Payer: PHP Commercial |
$270.51
|
| Rate for Payer: Priority Health SBD |
$200.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.86
|
| Rate for Payer: UHC Core |
$165.81
|
| Rate for Payer: UHC Exchange |
$125.07
|
| Rate for Payer: UMR Bronson Commercial |
$117.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.69
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$331.55
|
|
|
Service Code
|
NDC 62756046188
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.67 |
| Max. Negotiated Rate |
$298.39 |
| Rate for Payer: Aetna American Axle |
$215.51
|
| Rate for Payer: Aetna Commercial |
$281.82
|
| Rate for Payer: Aetna Medicare |
$165.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.51
|
| Rate for Payer: BCBS Complete |
$132.62
|
| Rate for Payer: Cash Price |
$265.24
|
| Rate for Payer: Cofinity Advantage |
$232.09
|
| Rate for Payer: Cofinity Commercial |
$285.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.24
|
| Rate for Payer: Healthscope Commercial |
$298.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.66
|
| Rate for Payer: PHP Commercial |
$281.82
|
| Rate for Payer: Priority Health SBD |
$208.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.51
|
| Rate for Payer: UHC Core |
$172.74
|
| Rate for Payer: UHC Exchange |
$130.30
|
| Rate for Payer: UMR Bronson Commercial |
$122.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.66
|
|
|
CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$3.28
|
|
|
Service Code
|
NDC 68084028111
|
| Hospital Charge Code |
12329
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$2.95 |
| Rate for Payer: Aetna American Axle |
$2.13
|
| Rate for Payer: Aetna Commercial |
$2.79
|
| Rate for Payer: Aetna Medicare |
$1.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.13
|
| Rate for Payer: BCBS Complete |
$1.31
|
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Cofinity Advantage |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.62
|
| Rate for Payer: Healthscope Commercial |
$2.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.46
|
| Rate for Payer: PHP Commercial |
$2.79
|
| Rate for Payer: Priority Health SBD |
$2.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC Core |
$1.71
|
| Rate for Payer: UHC Exchange |
$1.29
|
| Rate for Payer: UMR Bronson Commercial |
$1.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.46
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$312.48
|
|
|
Service Code
|
NDC 62756045788
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.62 |
| Max. Negotiated Rate |
$281.23 |
| Rate for Payer: Aetna American Axle |
$203.11
|
| Rate for Payer: Aetna Commercial |
$265.61
|
| Rate for Payer: Aetna Medicare |
$156.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.11
|
| Rate for Payer: BCBS Complete |
$124.99
|
| Rate for Payer: Cash Price |
$249.98
|
| Rate for Payer: Cofinity Advantage |
$218.74
|
| Rate for Payer: Cofinity Commercial |
$268.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.98
|
| Rate for Payer: Healthscope Commercial |
$281.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.36
|
| Rate for Payer: PHP Commercial |
$265.61
|
| Rate for Payer: Priority Health SBD |
$196.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.11
|
| Rate for Payer: UHC Core |
$162.80
|
| Rate for Payer: UHC Exchange |
$122.80
|
| Rate for Payer: UMR Bronson Commercial |
$115.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.36
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$320.16
|
|
|
Service Code
|
NDC 51079092320
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.46 |
| Max. Negotiated Rate |
$288.14 |
| Rate for Payer: Aetna American Axle |
$208.10
|
| Rate for Payer: Aetna Commercial |
$272.14
|
| Rate for Payer: Aetna Medicare |
$160.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.10
|
| Rate for Payer: BCBS Complete |
$128.06
|
| Rate for Payer: Cash Price |
$256.13
|
| Rate for Payer: Cofinity Advantage |
$224.11
|
| Rate for Payer: Cofinity Commercial |
$275.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.13
|
| Rate for Payer: Healthscope Commercial |
$288.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.12
|
| Rate for Payer: PHP Commercial |
$272.14
|
| Rate for Payer: Priority Health SBD |
$201.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.10
|
| Rate for Payer: UHC Core |
$166.80
|
| Rate for Payer: UHC Exchange |
$125.82
|
| Rate for Payer: UMR Bronson Commercial |
$118.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.12
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$320.16
|
|
|
Service Code
|
NDC 51079092320
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.87 |
| Max. Negotiated Rate |
$288.14 |
| Rate for Payer: Aetna American Axle |
$208.10
|
| Rate for Payer: Aetna Commercial |
$272.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.10
|
| Rate for Payer: Cash Price |
$256.13
|
| Rate for Payer: Cofinity Advantage |
$224.11
|
| Rate for Payer: Cofinity Commercial |
$275.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.13
|
| Rate for Payer: Healthscope Commercial |
$288.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.12
|
| Rate for Payer: PHP Commercial |
$272.14
|
| Rate for Payer: Priority Health SBD |
$201.70
|
| Rate for Payer: UMR Bronson Commercial |
$140.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.12
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$3.21
|
|
|
Service Code
|
NDC 51079092301
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$2.89 |
| Rate for Payer: Aetna American Axle |
$2.09
|
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: Aetna Medicare |
$1.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.09
|
| Rate for Payer: BCBS Complete |
$1.28
|
| Rate for Payer: Cash Price |
$2.57
|
| Rate for Payer: Cofinity Advantage |
$2.25
|
| Rate for Payer: Cofinity Commercial |
$2.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.57
|
| Rate for Payer: Healthscope Commercial |
$2.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.41
|
| Rate for Payer: PHP Commercial |
$2.73
|
| Rate for Payer: Priority Health SBD |
$2.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.09
|
| Rate for Payer: UHC Core |
$1.67
|
| Rate for Payer: UHC Exchange |
$1.26
|
| Rate for Payer: UMR Bronson Commercial |
$1.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.41
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$627.36
|
|
|
Service Code
|
NDC 00378009401
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$276.04 |
| Max. Negotiated Rate |
$564.62 |
| Rate for Payer: Aetna American Axle |
$407.78
|
| Rate for Payer: Aetna Commercial |
$533.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.78
|
| Rate for Payer: Cash Price |
$501.89
|
| Rate for Payer: Cofinity Advantage |
$439.15
|
| Rate for Payer: Cofinity Commercial |
$539.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$501.89
|
| Rate for Payer: Healthscope Commercial |
$564.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$439.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$470.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$533.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$470.52
|
| Rate for Payer: PHP Commercial |
$533.26
|
| Rate for Payer: Priority Health SBD |
$395.24
|
| Rate for Payer: UMR Bronson Commercial |
$276.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$470.52
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$312.48
|
|
|
Service Code
|
NDC 62756045788
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.49 |
| Max. Negotiated Rate |
$281.23 |
| Rate for Payer: Aetna American Axle |
$203.11
|
| Rate for Payer: Aetna Commercial |
$265.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.11
|
| Rate for Payer: Cash Price |
$249.98
|
| Rate for Payer: Cofinity Advantage |
$218.74
|
| Rate for Payer: Cofinity Commercial |
$268.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.98
|
| Rate for Payer: Healthscope Commercial |
$281.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.36
|
| Rate for Payer: PHP Commercial |
$265.61
|
| Rate for Payer: Priority Health SBD |
$196.86
|
| Rate for Payer: UMR Bronson Commercial |
$137.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.36
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$3.21
|
|
|
Service Code
|
NDC 51079092301
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$2.89 |
| Rate for Payer: Aetna American Axle |
$2.09
|
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.09
|
| Rate for Payer: Cash Price |
$2.57
|
| Rate for Payer: Cofinity Advantage |
$2.25
|
| Rate for Payer: Cofinity Commercial |
$2.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.57
|
| Rate for Payer: Healthscope Commercial |
$2.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.41
|
| Rate for Payer: PHP Commercial |
$2.73
|
| Rate for Payer: Priority Health SBD |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$1.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.41
|
|
|
CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$627.36
|
|
|
Service Code
|
NDC 00378009401
|
| Hospital Charge Code |
9409
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$232.12 |
| Max. Negotiated Rate |
$564.62 |
| Rate for Payer: Aetna American Axle |
$407.78
|
| Rate for Payer: Aetna Commercial |
$533.26
|
| Rate for Payer: Aetna Medicare |
$313.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.78
|
| Rate for Payer: BCBS Complete |
$250.94
|
| Rate for Payer: Cash Price |
$501.89
|
| Rate for Payer: Cofinity Advantage |
$439.15
|
| Rate for Payer: Cofinity Commercial |
$539.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$501.89
|
| Rate for Payer: Healthscope Commercial |
$564.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$439.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$470.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$501.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$533.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$470.52
|
| Rate for Payer: PHP Commercial |
$533.26
|
| Rate for Payer: Priority Health SBD |
$395.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.78
|
| Rate for Payer: UHC Core |
$326.85
|
| Rate for Payer: UHC Exchange |
$246.55
|
| Rate for Payer: UMR Bronson Commercial |
$232.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$470.52
|
|
|
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$262.61
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
39265
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$236.35 |
| Rate for Payer: Aetna American Axle |
$170.70
|
| Rate for Payer: Aetna American Axle |
$195.97
|
| Rate for Payer: Aetna American Axle |
$239.85
|
| Rate for Payer: Aetna American Axle |
$196.68
|
| Rate for Payer: Aetna American Axle |
$110.33
|
| Rate for Payer: Aetna American Axle |
$228.46
|
| Rate for Payer: Aetna American Axle |
$153.93
|
| Rate for Payer: Aetna American Axle |
$358.59
|
| Rate for Payer: Aetna American Axle |
$205.07
|
| Rate for Payer: Aetna American Axle |
$312.21
|
| Rate for Payer: Aetna American Axle |
$167.10
|
| Rate for Payer: Aetna American Axle |
$145.52
|
| Rate for Payer: Aetna American Axle |
$123.73
|
| Rate for Payer: Aetna American Axle |
$274.23
|
| Rate for Payer: Aetna American Axle |
$316.30
|
| Rate for Payer: Aetna Commercial |
$268.18
|
| Rate for Payer: Aetna Commercial |
$413.63
|
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: Aetna Commercial |
$298.76
|
| Rate for Payer: Aetna Commercial |
$257.19
|
| Rate for Payer: Aetna Commercial |
$313.65
|
| Rate for Payer: Aetna Commercial |
$256.27
|
| Rate for Payer: Aetna Commercial |
$144.28
|
| Rate for Payer: Aetna Commercial |
$223.22
|
| Rate for Payer: Aetna Commercial |
$358.61
|
| Rate for Payer: Aetna Commercial |
$190.30
|
| Rate for Payer: Aetna Commercial |
$218.51
|
| Rate for Payer: Aetna Commercial |
$408.27
|
| Rate for Payer: Aetna Commercial |
$468.92
|
| Rate for Payer: Aetna Commercial |
$201.30
|
| Rate for Payer: Aetna Medicare |
$111.94
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Aetna Medicare |
$240.16
|
| Rate for Payer: Aetna Medicare |
$157.75
|
| Rate for Payer: Aetna Medicare |
$210.94
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna Medicare |
$128.53
|
| Rate for Payer: Aetna Medicare |
$118.41
|
| Rate for Payer: Aetna Medicare |
$175.74
|
| Rate for Payer: Aetna Medicare |
$151.29
|
| Rate for Payer: Aetna Medicare |
$275.83
|
| Rate for Payer: Aetna Medicare |
$184.50
|
| Rate for Payer: Aetna Medicare |
$95.17
|
| Rate for Payer: Aetna Medicare |
$150.75
|
| Rate for Payer: Aetna Medicare |
$84.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.93
|
| Rate for Payer: BCBS Complete |
$126.20
|
| Rate for Payer: BCBS Complete |
$67.90
|
| Rate for Payer: BCBS Complete |
$76.14
|
| Rate for Payer: BCBS Complete |
$89.55
|
| Rate for Payer: BCBS Complete |
$220.67
|
| Rate for Payer: BCBS Complete |
$194.65
|
| Rate for Payer: BCBS Complete |
$94.73
|
| Rate for Payer: BCBS Complete |
$192.13
|
| Rate for Payer: BCBS Complete |
$102.83
|
| Rate for Payer: BCBS Complete |
$168.76
|
| Rate for Payer: BCBS Complete |
$105.04
|
| Rate for Payer: BCBS Complete |
$147.60
|
| Rate for Payer: BCBS Complete |
$120.60
|
| Rate for Payer: BCBS Complete |
$121.03
|
| Rate for Payer: BCBS Complete |
$140.59
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: Cash Price |
$384.26
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$389.30
|
| Rate for Payer: Cash Price |
$252.40
|
| Rate for Payer: Cash Price |
$441.34
|
| Rate for Payer: Cash Price |
$441.34
|
| Rate for Payer: Cash Price |
$384.26
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cash Price |
$252.40
|
| Rate for Payer: Cash Price |
$281.18
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cash Price |
$242.06
|
| Rate for Payer: Cash Price |
$189.46
|
| Rate for Payer: Cash Price |
$337.51
|
| Rate for Payer: Cash Price |
$281.18
|
| Rate for Payer: Cash Price |
$210.09
|
| Rate for Payer: Cash Price |
$242.06
|
| Rate for Payer: Cash Price |
$389.30
|
| Rate for Payer: Cash Price |
$210.09
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$135.79
|
| Rate for Payer: Cash Price |
$337.51
|
| Rate for Payer: Cash Price |
$135.79
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cash Price |
$189.46
|
| Rate for Payer: Cofinity Advantage |
$165.77
|
| Rate for Payer: Cofinity Advantage |
$133.25
|
| Rate for Payer: Cofinity Advantage |
$183.83
|
| Rate for Payer: Cofinity Advantage |
$340.63
|
| Rate for Payer: Cofinity Advantage |
$295.32
|
| Rate for Payer: Cofinity Advantage |
$220.85
|
| Rate for Payer: Cofinity Advantage |
$211.81
|
| Rate for Payer: Cofinity Advantage |
$156.72
|
| Rate for Payer: Cofinity Advantage |
$336.22
|
| Rate for Payer: Cofinity Advantage |
$258.30
|
| Rate for Payer: Cofinity Advantage |
$179.95
|
| Rate for Payer: Cofinity Advantage |
$246.04
|
| Rate for Payer: Cofinity Advantage |
$386.17
|
| Rate for Payer: Cofinity Advantage |
$211.05
|
| Rate for Payer: Cofinity Advantage |
$118.82
|
| Rate for Payer: Cofinity Commercial |
$302.27
|
| Rate for Payer: Cofinity Commercial |
$413.08
|
| Rate for Payer: Cofinity Commercial |
$418.49
|
| Rate for Payer: Cofinity Commercial |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$474.44
|
| Rate for Payer: Cofinity Commercial |
$221.08
|
| Rate for Payer: Cofinity Commercial |
$362.83
|
| Rate for Payer: Cofinity Commercial |
$192.54
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$225.84
|
| Rate for Payer: Cofinity Commercial |
$145.98
|
| Rate for Payer: Cofinity Commercial |
$317.34
|
| Rate for Payer: Cofinity Commercial |
$271.33
|
| Rate for Payer: Cofinity Commercial |
$259.29
|
| Rate for Payer: Cofinity Commercial |
$260.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.20
|
| Rate for Payer: Healthscope Commercial |
$271.35
|
| Rate for Payer: Healthscope Commercial |
$332.10
|
| Rate for Payer: Healthscope Commercial |
$236.35
|
| Rate for Payer: Healthscope Commercial |
$171.31
|
| Rate for Payer: Healthscope Commercial |
$316.33
|
| Rate for Payer: Healthscope Commercial |
$152.77
|
| Rate for Payer: Healthscope Commercial |
$379.70
|
| Rate for Payer: Healthscope Commercial |
$231.36
|
| Rate for Payer: Healthscope Commercial |
$432.29
|
| Rate for Payer: Healthscope Commercial |
$272.32
|
| Rate for Payer: Healthscope Commercial |
$283.95
|
| Rate for Payer: Healthscope Commercial |
$496.50
|
| Rate for Payer: Healthscope Commercial |
$213.14
|
| Rate for Payer: Healthscope Commercial |
$201.49
|
| Rate for Payer: Healthscope Commercial |
$437.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$295.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$258.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$281.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$295.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$389.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$413.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.62
|
| Rate for Payer: PHP Commercial |
$218.51
|
| Rate for Payer: PHP Commercial |
$313.65
|
| Rate for Payer: PHP Commercial |
$413.63
|
| Rate for Payer: PHP Commercial |
$190.30
|
| Rate for Payer: PHP Commercial |
$201.30
|
| Rate for Payer: PHP Commercial |
$257.19
|
| Rate for Payer: PHP Commercial |
$268.18
|
| Rate for Payer: PHP Commercial |
$256.27
|
| Rate for Payer: PHP Commercial |
$298.76
|
| Rate for Payer: PHP Commercial |
$358.61
|
| Rate for Payer: PHP Commercial |
$408.27
|
| Rate for Payer: PHP Commercial |
$223.22
|
| Rate for Payer: PHP Commercial |
$468.92
|
| Rate for Payer: PHP Commercial |
$144.28
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: Priority Health SBD |
$221.43
|
| Rate for Payer: Priority Health SBD |
$347.55
|
| Rate for Payer: Priority Health SBD |
$302.60
|
| Rate for Payer: Priority Health SBD |
$141.04
|
| Rate for Payer: Priority Health SBD |
$189.94
|
| Rate for Payer: Priority Health SBD |
$198.76
|
| Rate for Payer: Priority Health SBD |
$165.44
|
| Rate for Payer: Priority Health SBD |
$232.47
|
| Rate for Payer: Priority Health SBD |
$119.92
|
| Rate for Payer: Priority Health SBD |
$106.94
|
| Rate for Payer: Priority Health SBD |
$161.95
|
| Rate for Payer: Priority Health SBD |
$306.57
|
| Rate for Payer: Priority Health SBD |
$265.79
|
| Rate for Payer: Priority Health SBD |
$149.20
|
| Rate for Payer: Priority Health SBD |
$190.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Core |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UHC Exchange |
$4.83
|
| Rate for Payer: UMR Bronson Commercial |
$97.17
|
| Rate for Payer: UMR Bronson Commercial |
$111.56
|
| Rate for Payer: UMR Bronson Commercial |
$130.05
|
| Rate for Payer: UMR Bronson Commercial |
$204.12
|
| Rate for Payer: UMR Bronson Commercial |
$111.95
|
| Rate for Payer: UMR Bronson Commercial |
$177.72
|
| Rate for Payer: UMR Bronson Commercial |
$82.84
|
| Rate for Payer: UMR Bronson Commercial |
$87.62
|
| Rate for Payer: UMR Bronson Commercial |
$156.10
|
| Rate for Payer: UMR Bronson Commercial |
$180.05
|
| Rate for Payer: UMR Bronson Commercial |
$62.80
|
| Rate for Payer: UMR Bronson Commercial |
$116.73
|
| Rate for Payer: UMR Bronson Commercial |
$95.12
|
| Rate for Payer: UMR Bronson Commercial |
$70.43
|
| Rate for Payer: UMR Bronson Commercial |
$136.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.91
|
|
|
CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$236.82
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
39265
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$104.20 |
| Max. Negotiated Rate |
$213.14 |
| Rate for Payer: Aetna American Axle |
$153.93
|
| Rate for Payer: Aetna American Axle |
$196.68
|
| Rate for Payer: Aetna American Axle |
$228.46
|
| Rate for Payer: Aetna American Axle |
$110.33
|
| Rate for Payer: Aetna American Axle |
$145.52
|
| Rate for Payer: Aetna American Axle |
$123.73
|
| Rate for Payer: Aetna American Axle |
$316.30
|
| Rate for Payer: Aetna American Axle |
$195.97
|
| Rate for Payer: Aetna Commercial |
$413.63
|
| Rate for Payer: Aetna Commercial |
$298.76
|
| Rate for Payer: Aetna Commercial |
$201.30
|
| Rate for Payer: Aetna Commercial |
$144.28
|
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: Aetna Commercial |
$257.19
|
| Rate for Payer: Aetna Commercial |
$190.30
|
| Rate for Payer: Aetna Commercial |
$256.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.68
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cash Price |
$389.30
|
| Rate for Payer: Cash Price |
$189.46
|
| Rate for Payer: Cash Price |
$135.79
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cash Price |
$241.20
|
| Rate for Payer: Cash Price |
$242.06
|
| Rate for Payer: Cash Price |
$281.18
|
| Rate for Payer: Cofinity Advantage |
$340.63
|
| Rate for Payer: Cofinity Advantage |
$133.25
|
| Rate for Payer: Cofinity Advantage |
$165.77
|
| Rate for Payer: Cofinity Advantage |
$156.72
|
| Rate for Payer: Cofinity Advantage |
$118.82
|
| Rate for Payer: Cofinity Advantage |
$211.81
|
| Rate for Payer: Cofinity Advantage |
$246.04
|
| Rate for Payer: Cofinity Advantage |
$211.05
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$145.98
|
| Rate for Payer: Cofinity Commercial |
$192.54
|
| Rate for Payer: Cofinity Commercial |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$418.49
|
| Rate for Payer: Cofinity Commercial |
$259.29
|
| Rate for Payer: Cofinity Commercial |
$302.27
|
| Rate for Payer: Cofinity Commercial |
$260.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.79
|
| Rate for Payer: Healthscope Commercial |
$271.35
|
| Rate for Payer: Healthscope Commercial |
$213.14
|
| Rate for Payer: Healthscope Commercial |
$152.77
|
| Rate for Payer: Healthscope Commercial |
$437.96
|
| Rate for Payer: Healthscope Commercial |
$316.33
|
| Rate for Payer: Healthscope Commercial |
$201.49
|
| Rate for Payer: Healthscope Commercial |
$171.31
|
| Rate for Payer: Healthscope Commercial |
$272.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.96
|
| Rate for Payer: PHP Commercial |
$201.30
|
| Rate for Payer: PHP Commercial |
$256.27
|
| Rate for Payer: PHP Commercial |
$413.63
|
| Rate for Payer: PHP Commercial |
$190.30
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: PHP Commercial |
$144.28
|
| Rate for Payer: PHP Commercial |
$257.19
|
| Rate for Payer: PHP Commercial |
$298.76
|
| Rate for Payer: Priority Health SBD |
$190.63
|
| Rate for Payer: Priority Health SBD |
$221.43
|
| Rate for Payer: Priority Health SBD |
$306.57
|
| Rate for Payer: Priority Health SBD |
$119.92
|
| Rate for Payer: Priority Health SBD |
$106.94
|
| Rate for Payer: Priority Health SBD |
$141.04
|
| Rate for Payer: Priority Health SBD |
$149.20
|
| Rate for Payer: Priority Health SBD |
$189.94
|
| Rate for Payer: UMR Bronson Commercial |
$74.69
|
| Rate for Payer: UMR Bronson Commercial |
$132.66
|
| Rate for Payer: UMR Bronson Commercial |
$98.51
|
| Rate for Payer: UMR Bronson Commercial |
$214.11
|
| Rate for Payer: UMR Bronson Commercial |
$154.65
|
| Rate for Payer: UMR Bronson Commercial |
$104.20
|
| Rate for Payer: UMR Bronson Commercial |
$83.75
|
| Rate for Payer: UMR Bronson Commercial |
$133.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.61
|
|
|
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$103.47
|
|
|
Service Code
|
HCPCS J0675
|
| Hospital Charge Code |
9413
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$161.03 |
| Rate for Payer: Aetna American Axle |
$67.26
|
| Rate for Payer: Aetna American Axle |
$90.10
|
| Rate for Payer: Aetna American Axle |
$57.51
|
| Rate for Payer: Aetna American Axle |
$54.80
|
| Rate for Payer: Aetna American Axle |
$289.71
|
| Rate for Payer: Aetna American Axle |
$134.76
|
| Rate for Payer: Aetna American Axle |
$107.47
|
| Rate for Payer: Aetna American Axle |
$106.98
|
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: Aetna Commercial |
$117.83
|
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Commercial |
$87.95
|
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: Aetna Commercial |
$176.22
|
| Rate for Payer: Aetna Commercial |
$71.66
|
| Rate for Payer: Aetna Commercial |
$139.90
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Commercial |
$79.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cash Price |
$110.90
|
| Rate for Payer: Cash Price |
$132.27
|
| Rate for Payer: Cash Price |
$132.27
|
| Rate for Payer: Cash Price |
$67.45
|
| Rate for Payer: Cash Price |
$165.86
|
| Rate for Payer: Cash Price |
$70.78
|
| Rate for Payer: Cash Price |
$110.90
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cash Price |
$165.86
|
| Rate for Payer: Cash Price |
$70.78
|
| Rate for Payer: Cash Price |
$67.45
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cash Price |
$82.78
|
| Rate for Payer: Cash Price |
$82.78
|
| Rate for Payer: Cofinity Advantage |
$312.00
|
| Rate for Payer: Cofinity Advantage |
$61.93
|
| Rate for Payer: Cofinity Advantage |
$72.43
|
| Rate for Payer: Cofinity Advantage |
$145.12
|
| Rate for Payer: Cofinity Advantage |
$97.03
|
| Rate for Payer: Cofinity Advantage |
$115.74
|
| Rate for Payer: Cofinity Advantage |
$59.02
|
| Rate for Payer: Cofinity Advantage |
$115.21
|
| Rate for Payer: Cofinity Commercial |
$178.30
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Cofinity Commercial |
$72.51
|
| Rate for Payer: Cofinity Commercial |
$88.98
|
| Rate for Payer: Cofinity Commercial |
$119.21
|
| Rate for Payer: Cofinity Commercial |
$76.08
|
| Rate for Payer: Cofinity Commercial |
$142.19
|
| Rate for Payer: Cofinity Commercial |
$141.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$79.62
|
| Rate for Payer: Healthscope Commercial |
$75.88
|
| Rate for Payer: Healthscope Commercial |
$124.76
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Healthscope Commercial |
$93.12
|
| Rate for Payer: Healthscope Commercial |
$148.13
|
| Rate for Payer: Healthscope Commercial |
$186.59
|
| Rate for Payer: Healthscope Commercial |
$148.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.60
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicaid |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Mclaren Medicare |
$15.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: Meridian Medicaid |
$16.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.54
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Nomi Health Commercial |
$46.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.35
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE Medicare |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$75.20
|
| Rate for Payer: PHP Commercial |
$117.83
|
| Rate for Payer: PHP Commercial |
$87.95
|
| Rate for Payer: PHP Commercial |
$71.66
|
| Rate for Payer: PHP Commercial |
$140.54
|
| Rate for Payer: PHP Commercial |
$176.22
|
| Rate for Payer: PHP Commercial |
$139.90
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$161.03
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health SBD |
$65.19
|
| Rate for Payer: Priority Health SBD |
$104.16
|
| Rate for Payer: Priority Health SBD |
$87.33
|
| Rate for Payer: Priority Health SBD |
$280.80
|
| Rate for Payer: Priority Health SBD |
$55.74
|
| Rate for Payer: Priority Health SBD |
$130.61
|
| Rate for Payer: Priority Health SBD |
$103.69
|
| Rate for Payer: Priority Health SBD |
$53.12
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Priority Health Tiered Network |
$128.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Core |
$22.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHC Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: UMR Bronson Commercial |
$60.90
|
| Rate for Payer: UMR Bronson Commercial |
$76.71
|
| Rate for Payer: UMR Bronson Commercial |
$38.28
|
| Rate for Payer: UMR Bronson Commercial |
$32.73
|
| Rate for Payer: UMR Bronson Commercial |
$164.91
|
| Rate for Payer: UMR Bronson Commercial |
$51.29
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
| Rate for Payer: UMR Bronson Commercial |
$31.19
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.97
|
|
|
CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$165.34
|
|
|
Service Code
|
HCPCS J0675
|
| Hospital Charge Code |
9413
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$72.75 |
| Max. Negotiated Rate |
$148.81 |
| Rate for Payer: Aetna American Axle |
$107.47
|
| Rate for Payer: Aetna American Axle |
$289.71
|
| Rate for Payer: Aetna American Axle |
$54.80
|
| Rate for Payer: Aetna American Axle |
$67.26
|
| Rate for Payer: Aetna American Axle |
$106.98
|
| Rate for Payer: Aetna American Axle |
$90.10
|
| Rate for Payer: Aetna American Axle |
$57.51
|
| Rate for Payer: Aetna American Axle |
$134.76
|
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: Aetna Commercial |
$71.66
|
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Commercial |
$87.95
|
| Rate for Payer: Aetna Commercial |
$117.83
|
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: Aetna Commercial |
$139.90
|
| Rate for Payer: Aetna Commercial |
$176.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.71
|
| Rate for Payer: Cash Price |
$110.90
|
| Rate for Payer: Cash Price |
$70.78
|
| Rate for Payer: Cash Price |
$132.27
|
| Rate for Payer: Cash Price |
$82.78
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cash Price |
$165.86
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cash Price |
$67.45
|
| Rate for Payer: Cofinity Advantage |
$61.93
|
| Rate for Payer: Cofinity Advantage |
$97.03
|
| Rate for Payer: Cofinity Advantage |
$115.74
|
| Rate for Payer: Cofinity Advantage |
$115.21
|
| Rate for Payer: Cofinity Advantage |
$72.43
|
| Rate for Payer: Cofinity Advantage |
$312.00
|
| Rate for Payer: Cofinity Advantage |
$59.02
|
| Rate for Payer: Cofinity Advantage |
$145.12
|
| Rate for Payer: Cofinity Commercial |
$119.21
|
| Rate for Payer: Cofinity Commercial |
$88.98
|
| Rate for Payer: Cofinity Commercial |
$141.55
|
| Rate for Payer: Cofinity Commercial |
$142.19
|
| Rate for Payer: Cofinity Commercial |
$76.08
|
| Rate for Payer: Cofinity Commercial |
$178.30
|
| Rate for Payer: Cofinity Commercial |
$72.51
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.78
|
| Rate for Payer: Healthscope Commercial |
$186.59
|
| Rate for Payer: Healthscope Commercial |
$148.81
|
| Rate for Payer: Healthscope Commercial |
$93.12
|
| Rate for Payer: Healthscope Commercial |
$79.62
|
| Rate for Payer: Healthscope Commercial |
$75.88
|
| Rate for Payer: Healthscope Commercial |
$148.13
|
| Rate for Payer: Healthscope Commercial |
$124.76
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.35
|
| Rate for Payer: PHP Commercial |
$140.54
|
| Rate for Payer: PHP Commercial |
$176.22
|
| Rate for Payer: PHP Commercial |
$75.20
|
| Rate for Payer: PHP Commercial |
$139.90
|
| Rate for Payer: PHP Commercial |
$117.83
|
| Rate for Payer: PHP Commercial |
$87.95
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: PHP Commercial |
$71.66
|
| Rate for Payer: Priority Health SBD |
$280.80
|
| Rate for Payer: Priority Health SBD |
$53.12
|
| Rate for Payer: Priority Health SBD |
$55.74
|
| Rate for Payer: Priority Health SBD |
$87.33
|
| Rate for Payer: Priority Health SBD |
$65.19
|
| Rate for Payer: Priority Health SBD |
$103.69
|
| Rate for Payer: Priority Health SBD |
$104.16
|
| Rate for Payer: Priority Health SBD |
$130.61
|
| Rate for Payer: UMR Bronson Commercial |
$45.53
|
| Rate for Payer: UMR Bronson Commercial |
$91.22
|
| Rate for Payer: UMR Bronson Commercial |
$72.42
|
| Rate for Payer: UMR Bronson Commercial |
$38.93
|
| Rate for Payer: UMR Bronson Commercial |
$37.10
|
| Rate for Payer: UMR Bronson Commercial |
$72.75
|
| Rate for Payer: UMR Bronson Commercial |
$60.99
|
| Rate for Payer: UMR Bronson Commercial |
$196.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.23
|
|
|
CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS
|
Facility
|
IP
|
$28.25
|
|
|
Service Code
|
NDC 00023920515
|
| Hospital Charge Code |
27992
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$25.43 |
| Rate for Payer: Aetna American Axle |
$18.36
|
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.36
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Advantage |
$19.77
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$25.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.19
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: Priority Health SBD |
$17.80
|
| Rate for Payer: UMR Bronson Commercial |
$12.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
