|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,265.18
|
|
|
Service Code
|
NDC 50458055401
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$468.12 |
| Max. Negotiated Rate |
$1,138.66 |
| Rate for Payer: Aetna American Axle |
$822.37
|
| Rate for Payer: Aetna Commercial |
$1,075.40
|
| Rate for Payer: Aetna Medicare |
$632.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.37
|
| Rate for Payer: BCBS Complete |
$506.07
|
| Rate for Payer: Cash Price |
$1,012.14
|
| Rate for Payer: Cofinity Advantage |
$885.63
|
| Rate for Payer: Cofinity Commercial |
$1,088.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.14
|
| Rate for Payer: Healthscope Commercial |
$1,138.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,012.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.88
|
| Rate for Payer: PHP Commercial |
$1,075.40
|
| Rate for Payer: Priority Health SBD |
$797.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.37
|
| Rate for Payer: UHC Core |
$659.16
|
| Rate for Payer: UHC Exchange |
$497.22
|
| Rate for Payer: UMR Bronson Commercial |
$468.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.88
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,265.18
|
|
|
Service Code
|
NDC 50458055401
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$556.68 |
| Max. Negotiated Rate |
$1,138.66 |
| Rate for Payer: Aetna American Axle |
$822.37
|
| Rate for Payer: Aetna Commercial |
$1,075.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.37
|
| Rate for Payer: Cash Price |
$1,012.14
|
| Rate for Payer: Cofinity Advantage |
$885.63
|
| Rate for Payer: Cofinity Commercial |
$1,088.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.14
|
| Rate for Payer: Healthscope Commercial |
$1,138.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$885.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.88
|
| Rate for Payer: PHP Commercial |
$1,075.40
|
| Rate for Payer: Priority Health SBD |
$797.06
|
| Rate for Payer: UMR Bronson Commercial |
$556.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.88
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$2,523.92
|
|
|
Service Code
|
NDC 00378397893
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,110.52 |
| Max. Negotiated Rate |
$2,271.53 |
| Rate for Payer: Aetna American Axle |
$1,640.55
|
| Rate for Payer: Aetna Commercial |
$2,145.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,640.55
|
| Rate for Payer: Cash Price |
$2,019.14
|
| Rate for Payer: Cofinity Advantage |
$1,766.74
|
| Rate for Payer: Cofinity Commercial |
$2,170.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,019.14
|
| Rate for Payer: Healthscope Commercial |
$2,271.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,766.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,892.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,145.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,892.94
|
| Rate for Payer: PHP Commercial |
$2,145.33
|
| Rate for Payer: Priority Health SBD |
$1,590.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,892.94
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$223.67
|
|
|
Service Code
|
NDC 68180052406
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.76 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna American Axle |
$145.39
|
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna Medicare |
$111.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: BCBS Complete |
$89.47
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.39
|
| Rate for Payer: UHC Core |
$116.53
|
| Rate for Payer: UHC Exchange |
$87.90
|
| Rate for Payer: UMR Bronson Commercial |
$82.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.75
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$223.67
|
|
|
Service Code
|
NDC 43975035003
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna American Axle |
$145.39
|
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
| Rate for Payer: UMR Bronson Commercial |
$98.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.75
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$254.88
|
|
|
Service Code
|
NDC 65162028103
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.15 |
| Max. Negotiated Rate |
$229.39 |
| Rate for Payer: Aetna American Axle |
$165.67
|
| Rate for Payer: Aetna Commercial |
$216.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.67
|
| Rate for Payer: Cash Price |
$203.90
|
| Rate for Payer: Cofinity Advantage |
$178.42
|
| Rate for Payer: Cofinity Commercial |
$219.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.90
|
| Rate for Payer: Healthscope Commercial |
$229.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.16
|
| Rate for Payer: PHP Commercial |
$216.65
|
| Rate for Payer: Priority Health SBD |
$160.57
|
| Rate for Payer: UMR Bronson Commercial |
$112.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.16
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$344.10
|
|
|
Service Code
|
NDC 47335076583
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$151.40 |
| Max. Negotiated Rate |
$309.69 |
| Rate for Payer: Aetna American Axle |
$223.66
|
| Rate for Payer: Aetna Commercial |
$292.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.66
|
| Rate for Payer: Cash Price |
$275.28
|
| Rate for Payer: Cofinity Advantage |
$240.87
|
| Rate for Payer: Cofinity Commercial |
$295.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.28
|
| Rate for Payer: Healthscope Commercial |
$309.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.07
|
| Rate for Payer: PHP Commercial |
$292.49
|
| Rate for Payer: Priority Health SBD |
$216.78
|
| Rate for Payer: UMR Bronson Commercial |
$151.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.07
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,290.49
|
|
|
Service Code
|
NDC 50458055001
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$567.82 |
| Max. Negotiated Rate |
$1,161.44 |
| Rate for Payer: Aetna American Axle |
$838.82
|
| Rate for Payer: Aetna Commercial |
$1,096.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.82
|
| Rate for Payer: Cash Price |
$1,032.39
|
| Rate for Payer: Cofinity Advantage |
$903.34
|
| Rate for Payer: Cofinity Commercial |
$1,109.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.39
|
| Rate for Payer: Healthscope Commercial |
$1,161.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$903.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.87
|
| Rate for Payer: PHP Commercial |
$1,096.92
|
| Rate for Payer: Priority Health SBD |
$813.01
|
| Rate for Payer: UMR Bronson Commercial |
$567.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.87
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$254.88
|
|
|
Service Code
|
NDC 65162028103
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.31 |
| Max. Negotiated Rate |
$229.39 |
| Rate for Payer: Aetna American Axle |
$165.67
|
| Rate for Payer: Aetna Commercial |
$216.65
|
| Rate for Payer: Aetna Medicare |
$127.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.67
|
| Rate for Payer: BCBS Complete |
$101.95
|
| Rate for Payer: Cash Price |
$203.90
|
| Rate for Payer: Cofinity Advantage |
$178.42
|
| Rate for Payer: Cofinity Commercial |
$219.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.90
|
| Rate for Payer: Healthscope Commercial |
$229.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.16
|
| Rate for Payer: PHP Commercial |
$216.65
|
| Rate for Payer: Priority Health SBD |
$160.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.67
|
| Rate for Payer: UHC Core |
$132.79
|
| Rate for Payer: UHC Exchange |
$100.17
|
| Rate for Payer: UMR Bronson Commercial |
$94.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.16
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$223.67
|
|
|
Service Code
|
NDC 68180052406
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna American Axle |
$145.39
|
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
| Rate for Payer: UMR Bronson Commercial |
$98.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.75
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$344.10
|
|
|
Service Code
|
NDC 47335076583
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.32 |
| Max. Negotiated Rate |
$309.69 |
| Rate for Payer: Aetna American Axle |
$223.66
|
| Rate for Payer: Aetna Commercial |
$292.49
|
| Rate for Payer: Aetna Medicare |
$172.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.66
|
| Rate for Payer: BCBS Complete |
$137.64
|
| Rate for Payer: Cash Price |
$275.28
|
| Rate for Payer: Cofinity Advantage |
$240.87
|
| Rate for Payer: Cofinity Commercial |
$295.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.28
|
| Rate for Payer: Healthscope Commercial |
$309.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.07
|
| Rate for Payer: PHP Commercial |
$292.49
|
| Rate for Payer: Priority Health SBD |
$216.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.66
|
| Rate for Payer: UHC Core |
$179.28
|
| Rate for Payer: UHC Exchange |
$135.23
|
| Rate for Payer: UMR Bronson Commercial |
$127.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.07
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$223.67
|
|
|
Service Code
|
NDC 43975035003
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.76 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna American Axle |
$145.39
|
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna Medicare |
$111.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: BCBS Complete |
$89.47
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.39
|
| Rate for Payer: UHC Core |
$116.53
|
| Rate for Payer: UHC Exchange |
$87.90
|
| Rate for Payer: UMR Bronson Commercial |
$82.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.75
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,290.49
|
|
|
Service Code
|
NDC 50458055001
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$477.48 |
| Max. Negotiated Rate |
$1,161.44 |
| Rate for Payer: Aetna American Axle |
$838.82
|
| Rate for Payer: Aetna Commercial |
$1,096.92
|
| Rate for Payer: Aetna Medicare |
$645.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.82
|
| Rate for Payer: BCBS Complete |
$516.20
|
| Rate for Payer: Cash Price |
$1,032.39
|
| Rate for Payer: Cofinity Advantage |
$903.34
|
| Rate for Payer: Cofinity Commercial |
$1,109.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.39
|
| Rate for Payer: Healthscope Commercial |
$1,161.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$903.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,032.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.87
|
| Rate for Payer: PHP Commercial |
$1,096.92
|
| Rate for Payer: Priority Health SBD |
$813.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.82
|
| Rate for Payer: UHC Core |
$672.35
|
| Rate for Payer: UHC Exchange |
$507.16
|
| Rate for Payer: UMR Bronson Commercial |
$477.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.87
|
|
|
PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$5,204.61
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
119133
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$4,684.15 |
| Rate for Payer: Aetna American Axle |
$3,383.00
|
| Rate for Payer: Aetna Commercial |
$4,423.92
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,383.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$4,163.69
|
| Rate for Payer: Cash Price |
$4,163.69
|
| Rate for Payer: Cofinity Advantage |
$3,643.23
|
| Rate for Payer: Cofinity Commercial |
$4,475.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$4,684.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,643.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,903.46
|
| Rate for Payer: Mclaren Medicaid |
$15.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.92
|
| Rate for Payer: Nomi Health Commercial |
$45.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.46
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$4,423.92
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.66
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health SBD |
$3,278.90
|
| Rate for Payer: Priority Health Tiered Network |
$38.13
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.93
|
| Rate for Payer: UHC Core |
$24.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.08
|
| Rate for Payer: UHC Exchange |
$24.93
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,925.71
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,903.46
|
|
|
PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$5,204.61
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
119133
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,290.03 |
| Max. Negotiated Rate |
$4,684.15 |
| Rate for Payer: Aetna American Axle |
$3,383.00
|
| Rate for Payer: Aetna Commercial |
$4,423.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,383.00
|
| Rate for Payer: Cash Price |
$4,163.69
|
| Rate for Payer: Cofinity Advantage |
$3,643.23
|
| Rate for Payer: Cofinity Commercial |
$4,475.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.69
|
| Rate for Payer: Healthscope Commercial |
$4,684.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,643.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,903.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.46
|
| Rate for Payer: PHP Commercial |
$4,423.92
|
| Rate for Payer: Priority Health SBD |
$3,278.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,290.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,903.46
|
|
|
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$5,638.55
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
119134
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$5,074.69 |
| Rate for Payer: Aetna American Axle |
$3,665.06
|
| Rate for Payer: Aetna Commercial |
$4,792.77
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,665.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$4,510.84
|
| Rate for Payer: Cash Price |
$4,510.84
|
| Rate for Payer: Cofinity Advantage |
$3,946.99
|
| Rate for Payer: Cofinity Commercial |
$4,849.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,510.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$5,074.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,946.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,228.91
|
| Rate for Payer: Mclaren Medicaid |
$15.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,792.77
|
| Rate for Payer: Nomi Health Commercial |
$45.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,228.91
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$4,792.77
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.66
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health SBD |
$3,552.29
|
| Rate for Payer: Priority Health Tiered Network |
$38.13
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.93
|
| Rate for Payer: UHC Core |
$24.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.08
|
| Rate for Payer: UHC Exchange |
$24.93
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,086.26
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,228.91
|
|
|
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$5,638.55
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
119134
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,480.96 |
| Max. Negotiated Rate |
$5,074.69 |
| Rate for Payer: Aetna American Axle |
$3,665.06
|
| Rate for Payer: Aetna Commercial |
$4,792.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,665.06
|
| Rate for Payer: Cash Price |
$4,510.84
|
| Rate for Payer: Cofinity Advantage |
$3,946.99
|
| Rate for Payer: Cofinity Commercial |
$4,849.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,510.84
|
| Rate for Payer: Healthscope Commercial |
$5,074.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,946.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,228.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,792.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,228.91
|
| Rate for Payer: PHP Commercial |
$4,792.77
|
| Rate for Payer: Priority Health SBD |
$3,552.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,480.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,228.91
|
|
|
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$8,553.69
|
|
|
Service Code
|
HCPCS 90378
|
| Hospital Charge Code |
41675
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,763.62 |
| Max. Negotiated Rate |
$7,698.32 |
| Rate for Payer: Aetna American Axle |
$5,559.90
|
| Rate for Payer: Aetna Commercial |
$7,270.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,559.90
|
| Rate for Payer: Cash Price |
$6,842.95
|
| Rate for Payer: Cofinity Advantage |
$5,987.58
|
| Rate for Payer: Cofinity Commercial |
$7,356.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,842.95
|
| Rate for Payer: Healthscope Commercial |
$7,698.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,987.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,415.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,270.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,415.27
|
| Rate for Payer: PHP Commercial |
$7,270.64
|
| Rate for Payer: Priority Health SBD |
$5,388.82
|
| Rate for Payer: UMR Bronson Commercial |
$3,763.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,415.27
|
|
|
PALIVIZUMAB 100 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$8,553.69
|
|
|
Service Code
|
HCPCS 90378
|
| Hospital Charge Code |
41675
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$228.42 |
| Max. Negotiated Rate |
$7,698.32 |
| Rate for Payer: Aetna American Axle |
$5,559.90
|
| Rate for Payer: Aetna Commercial |
$7,270.64
|
| Rate for Payer: Aetna Medicare |
$454.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,559.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,794.43
|
| Rate for Payer: BCN Commercial |
$5,794.43
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: Cash Price |
$6,842.95
|
| Rate for Payer: Cash Price |
$6,842.95
|
| Rate for Payer: Cofinity Advantage |
$5,987.58
|
| Rate for Payer: Cofinity Commercial |
$7,356.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,842.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Healthscope Commercial |
$7,698.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,987.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,415.27
|
| Rate for Payer: Mclaren Medicaid |
$436.75
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$458.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,270.64
|
| Rate for Payer: Nomi Health Commercial |
$1,310.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,415.27
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PHP Commercial |
$7,270.64
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,377.51
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health SBD |
$5,388.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.01
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.43
|
| Rate for Payer: UHC Core |
$480.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Exchange |
$480.43
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: UMR Bronson Commercial |
$3,164.87
|
| Rate for Payer: VA VA |
$436.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,415.27
|
|
|
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$7,881.83
|
|
|
Service Code
|
HCPCS 90378
|
| Hospital Charge Code |
115944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$228.42 |
| Max. Negotiated Rate |
$7,093.65 |
| Rate for Payer: Aetna American Axle |
$5,123.19
|
| Rate for Payer: Aetna American Axle |
$3,786.98
|
| Rate for Payer: Aetna Commercial |
$4,952.20
|
| Rate for Payer: Aetna Commercial |
$6,699.56
|
| Rate for Payer: Aetna Medicare |
$454.22
|
| Rate for Payer: Aetna Medicare |
$454.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,786.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,123.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,794.43
|
| Rate for Payer: BCBS Trust/PPO |
$5,794.43
|
| Rate for Payer: BCN Commercial |
$5,794.43
|
| Rate for Payer: BCN Commercial |
$5,794.43
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: Cash Price |
$4,660.90
|
| Rate for Payer: Cash Price |
$6,305.46
|
| Rate for Payer: Cash Price |
$6,305.46
|
| Rate for Payer: Cash Price |
$4,660.90
|
| Rate for Payer: Cofinity Advantage |
$5,517.28
|
| Rate for Payer: Cofinity Advantage |
$4,078.28
|
| Rate for Payer: Cofinity Commercial |
$5,010.46
|
| Rate for Payer: Cofinity Commercial |
$6,778.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,660.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,305.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Healthscope Commercial |
$5,243.51
|
| Rate for Payer: Healthscope Commercial |
$7,093.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,517.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,078.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,369.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,911.37
|
| Rate for Payer: Mclaren Medicaid |
$436.75
|
| Rate for Payer: Mclaren Medicaid |
$436.75
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$458.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,952.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,699.56
|
| Rate for Payer: Nomi Health Commercial |
$1,310.25
|
| Rate for Payer: Nomi Health Commercial |
$1,310.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,911.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,369.59
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PHP Commercial |
$4,952.20
|
| Rate for Payer: PHP Commercial |
$6,699.56
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,377.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,377.51
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health SBD |
$3,670.46
|
| Rate for Payer: Priority Health SBD |
$4,965.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.01
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.43
|
| Rate for Payer: UHC Core |
$480.43
|
| Rate for Payer: UHC Core |
$480.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Exchange |
$480.43
|
| Rate for Payer: UHC Exchange |
$480.43
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: UMR Bronson Commercial |
$2,155.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,916.28
|
| Rate for Payer: VA VA |
$436.75
|
| Rate for Payer: VA VA |
$436.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,911.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,369.59
|
|
|
PALIVIZUMAB 50 MG/0.5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$5,826.12
|
|
|
Service Code
|
HCPCS 90378
|
| Hospital Charge Code |
115944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,563.49 |
| Max. Negotiated Rate |
$5,243.51 |
| Rate for Payer: Aetna American Axle |
$3,786.98
|
| Rate for Payer: Aetna American Axle |
$5,123.19
|
| Rate for Payer: Aetna Commercial |
$4,952.20
|
| Rate for Payer: Aetna Commercial |
$6,699.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,786.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,123.19
|
| Rate for Payer: Cash Price |
$4,660.90
|
| Rate for Payer: Cash Price |
$6,305.46
|
| Rate for Payer: Cofinity Advantage |
$5,517.28
|
| Rate for Payer: Cofinity Advantage |
$4,078.28
|
| Rate for Payer: Cofinity Commercial |
$6,778.37
|
| Rate for Payer: Cofinity Commercial |
$5,010.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,660.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,305.46
|
| Rate for Payer: Healthscope Commercial |
$5,243.51
|
| Rate for Payer: Healthscope Commercial |
$7,093.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,517.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,078.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,369.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,911.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,952.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,699.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,369.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,911.37
|
| Rate for Payer: PHP Commercial |
$4,952.20
|
| Rate for Payer: PHP Commercial |
$6,699.56
|
| Rate for Payer: Priority Health SBD |
$4,965.55
|
| Rate for Payer: Priority Health SBD |
$3,670.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,563.49
|
| Rate for Payer: UMR Bronson Commercial |
$3,468.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,369.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,911.37
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$187.17
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
36591
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.35 |
| Max. Negotiated Rate |
$168.45 |
| Rate for Payer: Aetna American Axle |
$121.66
|
| Rate for Payer: Aetna American Axle |
$54.33
|
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Commercial |
$159.09
|
| Rate for Payer: Aetna Commercial |
$71.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$149.74
|
| Rate for Payer: Cash Price |
$66.86
|
| Rate for Payer: Cofinity Advantage |
$58.51
|
| Rate for Payer: Cofinity Advantage |
$131.02
|
| Rate for Payer: Cofinity Advantage |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$160.97
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.86
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Healthscope Commercial |
$75.22
|
| Rate for Payer: Healthscope Commercial |
$168.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$159.09
|
| Rate for Payer: PHP Commercial |
$71.04
|
| Rate for Payer: Priority Health SBD |
$117.92
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Priority Health SBD |
$52.66
|
| Rate for Payer: UMR Bronson Commercial |
$82.35
|
| Rate for Payer: UMR Bronson Commercial |
$36.78
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.69
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$168.51
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
36591
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$151.66 |
| Rate for Payer: Aetna American Axle |
$109.53
|
| Rate for Payer: Aetna American Axle |
$117.13
|
| Rate for Payer: Aetna American Axle |
$166.24
|
| Rate for Payer: Aetna American Axle |
$121.66
|
| Rate for Payer: Aetna American Axle |
$72.09
|
| Rate for Payer: Aetna American Axle |
$67.80
|
| Rate for Payer: Aetna American Axle |
$54.33
|
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna American Axle |
$179.76
|
| Rate for Payer: Aetna Commercial |
$159.09
|
| Rate for Payer: Aetna Commercial |
$94.27
|
| Rate for Payer: Aetna Commercial |
$143.23
|
| Rate for Payer: Aetna Commercial |
$88.66
|
| Rate for Payer: Aetna Commercial |
$153.17
|
| Rate for Payer: Aetna Commercial |
$217.39
|
| Rate for Payer: Aetna Commercial |
$235.07
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Commercial |
$71.04
|
| Rate for Payer: Aetna Medicare |
$84.25
|
| Rate for Payer: Aetna Medicare |
$55.45
|
| Rate for Payer: Aetna Medicare |
$138.28
|
| Rate for Payer: Aetna Medicare |
$52.16
|
| Rate for Payer: Aetna Medicare |
$41.79
|
| Rate for Payer: Aetna Medicare |
$93.58
|
| Rate for Payer: Aetna Medicare |
$90.10
|
| Rate for Payer: Aetna Medicare |
$35.70
|
| Rate for Payer: Aetna Medicare |
$127.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.13
|
| Rate for Payer: BCBS Complete |
$44.36
|
| Rate for Payer: BCBS Complete |
$67.40
|
| Rate for Payer: BCBS Complete |
$102.30
|
| Rate for Payer: BCBS Complete |
$72.08
|
| Rate for Payer: BCBS Complete |
$110.62
|
| Rate for Payer: BCBS Complete |
$74.87
|
| Rate for Payer: BCBS Complete |
$33.43
|
| Rate for Payer: BCBS Complete |
$28.56
|
| Rate for Payer: BCBS Complete |
$41.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: Cash Price |
$204.60
|
| Rate for Payer: Cash Price |
$88.73
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$149.74
|
| Rate for Payer: Cash Price |
$144.16
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$66.86
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cash Price |
$149.74
|
| Rate for Payer: Cash Price |
$134.81
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cash Price |
$66.86
|
| Rate for Payer: Cash Price |
$134.81
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$88.73
|
| Rate for Payer: Cash Price |
$144.16
|
| Rate for Payer: Cash Price |
$204.60
|
| Rate for Payer: Cofinity Advantage |
$77.64
|
| Rate for Payer: Cofinity Advantage |
$117.96
|
| Rate for Payer: Cofinity Advantage |
$73.02
|
| Rate for Payer: Cofinity Advantage |
$126.14
|
| Rate for Payer: Cofinity Advantage |
$131.02
|
| Rate for Payer: Cofinity Advantage |
$179.03
|
| Rate for Payer: Cofinity Advantage |
$193.59
|
| Rate for Payer: Cofinity Advantage |
$49.98
|
| Rate for Payer: Cofinity Advantage |
$58.51
|
| Rate for Payer: Cofinity Commercial |
$95.38
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$237.83
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$160.97
|
| Rate for Payer: Cofinity Commercial |
$144.92
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$154.97
|
| Rate for Payer: Cofinity Commercial |
$219.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.81
|
| Rate for Payer: Healthscope Commercial |
$151.66
|
| Rate for Payer: Healthscope Commercial |
$99.82
|
| Rate for Payer: Healthscope Commercial |
$93.88
|
| Rate for Payer: Healthscope Commercial |
$75.22
|
| Rate for Payer: Healthscope Commercial |
$162.18
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Healthscope Commercial |
$248.90
|
| Rate for Payer: Healthscope Commercial |
$230.18
|
| Rate for Payer: Healthscope Commercial |
$168.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.55
|
| Rate for Payer: PHP Commercial |
$143.23
|
| Rate for Payer: PHP Commercial |
$153.17
|
| Rate for Payer: PHP Commercial |
$159.09
|
| Rate for Payer: PHP Commercial |
$71.04
|
| Rate for Payer: PHP Commercial |
$217.39
|
| Rate for Payer: PHP Commercial |
$88.66
|
| Rate for Payer: PHP Commercial |
$94.27
|
| Rate for Payer: PHP Commercial |
$235.07
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health SBD |
$117.92
|
| Rate for Payer: Priority Health SBD |
$174.23
|
| Rate for Payer: Priority Health SBD |
$69.87
|
| Rate for Payer: Priority Health SBD |
$106.16
|
| Rate for Payer: Priority Health SBD |
$161.12
|
| Rate for Payer: Priority Health SBD |
$52.66
|
| Rate for Payer: Priority Health SBD |
$65.72
|
| Rate for Payer: Priority Health SBD |
$113.53
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UMR Bronson Commercial |
$94.63
|
| Rate for Payer: UMR Bronson Commercial |
$62.35
|
| Rate for Payer: UMR Bronson Commercial |
$69.25
|
| Rate for Payer: UMR Bronson Commercial |
$102.32
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: UMR Bronson Commercial |
$30.92
|
| Rate for Payer: UMR Bronson Commercial |
$38.59
|
| Rate for Payer: UMR Bronson Commercial |
$41.04
|
| Rate for Payer: UMR Bronson Commercial |
$66.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.18
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$129.64
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
188040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$57.04 |
| Max. Negotiated Rate |
$116.68 |
| Rate for Payer: Aetna American Axle |
$84.27
|
| Rate for Payer: Aetna American Axle |
$171.32
|
| Rate for Payer: Aetna Commercial |
$110.19
|
| Rate for Payer: Aetna Commercial |
$224.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.32
|
| Rate for Payer: Cash Price |
$103.71
|
| Rate for Payer: Cash Price |
$210.86
|
| Rate for Payer: Cofinity Advantage |
$184.50
|
| Rate for Payer: Cofinity Advantage |
$90.75
|
| Rate for Payer: Cofinity Commercial |
$226.67
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.86
|
| Rate for Payer: Healthscope Commercial |
$116.68
|
| Rate for Payer: Healthscope Commercial |
$237.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.68
|
| Rate for Payer: PHP Commercial |
$110.19
|
| Rate for Payer: PHP Commercial |
$224.03
|
| Rate for Payer: Priority Health SBD |
$166.05
|
| Rate for Payer: Priority Health SBD |
$81.67
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
| Rate for Payer: UMR Bronson Commercial |
$115.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.68
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$129.64
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
188040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$116.68 |
| Rate for Payer: Aetna American Axle |
$84.27
|
| Rate for Payer: Aetna American Axle |
$171.32
|
| Rate for Payer: Aetna Commercial |
$110.19
|
| Rate for Payer: Aetna Commercial |
$224.03
|
| Rate for Payer: Aetna Medicare |
$64.82
|
| Rate for Payer: Aetna Medicare |
$131.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.32
|
| Rate for Payer: BCBS Complete |
$105.43
|
| Rate for Payer: BCBS Complete |
$51.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: Cash Price |
$103.71
|
| Rate for Payer: Cash Price |
$210.86
|
| Rate for Payer: Cash Price |
$103.71
|
| Rate for Payer: Cash Price |
$210.86
|
| Rate for Payer: Cofinity Advantage |
$90.75
|
| Rate for Payer: Cofinity Advantage |
$184.50
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Cofinity Commercial |
$226.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.86
|
| Rate for Payer: Healthscope Commercial |
$116.68
|
| Rate for Payer: Healthscope Commercial |
$237.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.23
|
| Rate for Payer: PHP Commercial |
$110.19
|
| Rate for Payer: PHP Commercial |
$224.03
|
| Rate for Payer: Priority Health SBD |
$81.67
|
| Rate for Payer: Priority Health SBD |
$166.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UMR Bronson Commercial |
$47.97
|
| Rate for Payer: UMR Bronson Commercial |
$97.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.68
|
|
