|
ORITAVANCIN 1,200 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$12,904.58
|
|
|
Service Code
|
HCPCS J2406
|
| Hospital Charge Code |
197251
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$11,614.12 |
| Rate for Payer: Aetna American Axle |
$8,387.98
|
| Rate for Payer: Aetna Commercial |
$10,968.89
|
| Rate for Payer: Aetna Medicare |
$44.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,387.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.10
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$42.48
|
| Rate for Payer: BCN Medicare Advantage |
$42.48
|
| Rate for Payer: Cash Price |
$10,323.66
|
| Rate for Payer: Cash Price |
$10,323.66
|
| Rate for Payer: Cofinity Commercial |
$9,033.21
|
| Rate for Payer: Cofinity Commercial |
$11,097.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,033.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,323.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.48
|
| Rate for Payer: Healthscope Commercial |
$11,614.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,033.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,678.43
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Mclaren Medicare |
$42.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.60
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,968.89
|
| Rate for Payer: PACE Medicare |
$40.36
|
| Rate for Payer: PACE SWMI |
$42.48
|
| Rate for Payer: PHP Commercial |
$10,968.89
|
| Rate for Payer: PHP Medicare Advantage |
$42.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,387.98
|
| Rate for Payer: Priority Health Medicare |
$42.48
|
| Rate for Payer: Priority Health SBD |
$8,129.89
|
| Rate for Payer: Railroad Medicare Medicare |
$42.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.48
|
| Rate for Payer: UHC Exchange |
$81.18
|
| Rate for Payer: UHC Medicare Advantage |
$42.48
|
| Rate for Payer: UHCCP Medicaid |
$22.77
|
| Rate for Payer: UMR Bronson Commercial |
$4,774.69
|
| Rate for Payer: VA VA |
$42.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,678.43
|
|
|
ORITAVANCIN 400 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$10,363.71
|
|
|
Service Code
|
HCPCS J2407
|
| Hospital Charge Code |
172319
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4,560.03 |
| Max. Negotiated Rate |
$9,327.34 |
| Rate for Payer: Aetna American Axle |
$6,736.41
|
| Rate for Payer: Aetna American Axle |
$2,245.47
|
| Rate for Payer: Aetna Commercial |
$8,809.15
|
| Rate for Payer: Aetna Commercial |
$2,936.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,736.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,245.47
|
| Rate for Payer: Cash Price |
$8,290.97
|
| Rate for Payer: Cash Price |
$2,763.66
|
| Rate for Payer: Cofinity Commercial |
$2,970.93
|
| Rate for Payer: Cofinity Commercial |
$2,418.20
|
| Rate for Payer: Cofinity Commercial |
$7,254.60
|
| Rate for Payer: Cofinity Commercial |
$8,912.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,254.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,418.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,290.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,763.66
|
| Rate for Payer: Healthscope Commercial |
$9,327.34
|
| Rate for Payer: Healthscope Commercial |
$3,109.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,254.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,418.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,772.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,590.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,936.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,809.15
|
| Rate for Payer: PHP Commercial |
$2,936.38
|
| Rate for Payer: PHP Commercial |
$8,809.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,736.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.47
|
| Rate for Payer: Priority Health SBD |
$6,529.14
|
| Rate for Payer: Priority Health SBD |
$2,176.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,560.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,520.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,772.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,590.93
|
|
|
ORITAVANCIN 400 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,454.57
|
|
|
Service Code
|
HCPCS J2407
|
| Hospital Charge Code |
172319
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.37 |
| Max. Negotiated Rate |
$3,109.11 |
| Rate for Payer: Aetna American Axle |
$2,245.47
|
| Rate for Payer: Aetna American Axle |
$6,736.41
|
| Rate for Payer: Aetna Commercial |
$8,809.15
|
| Rate for Payer: Aetna Commercial |
$2,936.38
|
| Rate for Payer: Aetna Medicare |
$29.83
|
| Rate for Payer: Aetna Medicare |
$29.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,245.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,736.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.85
|
| Rate for Payer: BCBS Complete |
$16.14
|
| Rate for Payer: BCBS Complete |
$16.14
|
| Rate for Payer: BCBS MAPPO |
$28.68
|
| Rate for Payer: BCBS MAPPO |
$28.68
|
| Rate for Payer: BCN Medicare Advantage |
$28.68
|
| Rate for Payer: BCN Medicare Advantage |
$28.68
|
| Rate for Payer: Cash Price |
$8,290.97
|
| Rate for Payer: Cash Price |
$2,763.66
|
| Rate for Payer: Cash Price |
$2,763.66
|
| Rate for Payer: Cash Price |
$8,290.97
|
| Rate for Payer: Cofinity Commercial |
$7,254.60
|
| Rate for Payer: Cofinity Commercial |
$8,912.79
|
| Rate for Payer: Cofinity Commercial |
$2,418.20
|
| Rate for Payer: Cofinity Commercial |
$2,970.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,254.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,418.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,763.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,290.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.68
|
| Rate for Payer: Healthscope Commercial |
$3,109.11
|
| Rate for Payer: Healthscope Commercial |
$9,327.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,418.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,254.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,772.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,590.93
|
| Rate for Payer: Mclaren Medicaid |
$15.37
|
| Rate for Payer: Mclaren Medicaid |
$15.37
|
| Rate for Payer: Mclaren Medicare |
$28.68
|
| Rate for Payer: Mclaren Medicare |
$28.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.11
|
| Rate for Payer: Meridian Medicaid |
$16.14
|
| Rate for Payer: Meridian Medicaid |
$16.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,936.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,809.15
|
| Rate for Payer: PACE Medicare |
$27.25
|
| Rate for Payer: PACE Medicare |
$27.25
|
| Rate for Payer: PACE SWMI |
$28.68
|
| Rate for Payer: PACE SWMI |
$28.68
|
| Rate for Payer: PHP Commercial |
$8,809.15
|
| Rate for Payer: PHP Commercial |
$2,936.38
|
| Rate for Payer: PHP Medicare Advantage |
$28.68
|
| Rate for Payer: PHP Medicare Advantage |
$28.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,736.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.47
|
| Rate for Payer: Priority Health Medicare |
$28.68
|
| Rate for Payer: Priority Health Medicare |
$28.68
|
| Rate for Payer: Priority Health SBD |
$6,529.14
|
| Rate for Payer: Priority Health SBD |
$2,176.38
|
| Rate for Payer: Railroad Medicare Medicare |
$28.68
|
| Rate for Payer: Railroad Medicare Medicare |
$28.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.68
|
| Rate for Payer: UHC Exchange |
$54.81
|
| Rate for Payer: UHC Exchange |
$54.81
|
| Rate for Payer: UHC Medicare Advantage |
$28.68
|
| Rate for Payer: UHC Medicare Advantage |
$28.68
|
| Rate for Payer: UHCCP Medicaid |
$15.37
|
| Rate for Payer: UHCCP Medicaid |
$15.37
|
| Rate for Payer: UMR Bronson Commercial |
$3,834.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,278.19
|
| Rate for Payer: VA VA |
$28.68
|
| Rate for Payer: VA VA |
$28.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,590.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,772.78
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$43.19
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$38.87 |
| Rate for Payer: Aetna American Axle |
$28.07
|
| Rate for Payer: Aetna American Axle |
$28.71
|
| Rate for Payer: Aetna Commercial |
$36.71
|
| Rate for Payer: Aetna Commercial |
$37.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.71
|
| Rate for Payer: Cash Price |
$34.55
|
| Rate for Payer: Cash Price |
$35.34
|
| Rate for Payer: Cofinity Commercial |
$37.99
|
| Rate for Payer: Cofinity Commercial |
$30.92
|
| Rate for Payer: Cofinity Commercial |
$30.23
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.34
|
| Rate for Payer: Healthscope Commercial |
$38.87
|
| Rate for Payer: Healthscope Commercial |
$39.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.71
|
| Rate for Payer: PHP Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$36.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.71
|
| Rate for Payer: Priority Health SBD |
$27.21
|
| Rate for Payer: Priority Health SBD |
$27.83
|
| Rate for Payer: UMR Bronson Commercial |
$19.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.13
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$43.19
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$38.87 |
| Rate for Payer: Aetna American Axle |
$28.07
|
| Rate for Payer: Aetna American Axle |
$28.71
|
| Rate for Payer: Aetna Commercial |
$36.71
|
| Rate for Payer: Aetna Commercial |
$37.54
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: Aetna Medicare |
$22.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.71
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS Complete |
$17.28
|
| Rate for Payer: Cash Price |
$34.55
|
| Rate for Payer: Cash Price |
$35.34
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$30.23
|
| Rate for Payer: Cofinity Commercial |
$30.92
|
| Rate for Payer: Cofinity Commercial |
$37.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.34
|
| Rate for Payer: Healthscope Commercial |
$39.75
|
| Rate for Payer: Healthscope Commercial |
$38.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$36.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.71
|
| Rate for Payer: Priority Health SBD |
$27.83
|
| Rate for Payer: Priority Health SBD |
$27.21
|
| Rate for Payer: UMR Bronson Commercial |
$15.98
|
| Rate for Payer: UMR Bronson Commercial |
$16.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.39
|
|
|
ORTHODONTIC WAX
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 09900000566
|
| Hospital Charge Code |
168918
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna American Axle |
$1.30
|
| Rate for Payer: Aetna Commercial |
$1.70
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$1.40
|
| Rate for Payer: Cofinity Commercial |
$1.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.60
|
| Rate for Payer: Healthscope Commercial |
$1.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.70
|
| Rate for Payer: PHP Commercial |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
| Rate for Payer: Priority Health SBD |
$1.26
|
| Rate for Payer: UMR Bronson Commercial |
$0.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.50
|
|
|
ORTHODONTIC WAX
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
NDC 09900000566
|
| Hospital Charge Code |
168918
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna American Axle |
$1.30
|
| Rate for Payer: Aetna Commercial |
$1.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.30
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$1.40
|
| Rate for Payer: Cofinity Commercial |
$1.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.60
|
| Rate for Payer: Healthscope Commercial |
$1.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.70
|
| Rate for Payer: PHP Commercial |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
| Rate for Payer: Priority Health SBD |
$1.26
|
| Rate for Payer: UMR Bronson Commercial |
$0.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.50
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$273.73
|
|
|
Service Code
|
NDC 69238126401
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$246.36 |
| Rate for Payer: Aetna American Axle |
$177.92
|
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.92
|
| Rate for Payer: Cash Price |
$218.98
|
| Rate for Payer: Cofinity Commercial |
$191.61
|
| Rate for Payer: Cofinity Commercial |
$235.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.98
|
| Rate for Payer: Healthscope Commercial |
$246.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.67
|
| Rate for Payer: PHP Commercial |
$232.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.92
|
| Rate for Payer: Priority Health SBD |
$172.45
|
| Rate for Payer: UMR Bronson Commercial |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.30
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna American Axle |
$25.46
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.46
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health SBD |
$24.68
|
| Rate for Payer: UMR Bronson Commercial |
$17.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.41 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna American Axle |
$311.67
|
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: Aetna Medicare |
$239.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.67
|
| Rate for Payer: BCBS Complete |
$191.80
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$335.64
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$335.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.59
|
| Rate for Payer: Healthscope Commercial |
$431.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.57
|
| Rate for Payer: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| Rate for Payer: Priority Health SBD |
$302.08
|
| Rate for Payer: UMR Bronson Commercial |
$177.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$207.39
|
|
|
Service Code
|
NDC 70710100802
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.25 |
| Max. Negotiated Rate |
$186.65 |
| Rate for Payer: Aetna American Axle |
$134.80
|
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.80
|
| Rate for Payer: Cash Price |
$165.91
|
| Rate for Payer: Cofinity Commercial |
$145.17
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.91
|
| Rate for Payer: Healthscope Commercial |
$186.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.28
|
| Rate for Payer: PHP Commercial |
$176.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.80
|
| Rate for Payer: Priority Health SBD |
$130.66
|
| Rate for Payer: UMR Bronson Commercial |
$91.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.70 |
| Max. Negotiated Rate |
$289.85 |
| Rate for Payer: Aetna American Axle |
$209.33
|
| Rate for Payer: Aetna Commercial |
$273.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.33
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$225.44
|
| Rate for Payer: Cofinity Commercial |
$276.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.44
|
| 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: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: PHP Commercial |
$273.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: UMR Bronson Commercial |
$141.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
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 Commercial |
$225.44
|
| Rate for Payer: Cofinity Commercial |
$276.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.44
|
| 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: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: PHP Commercial |
$273.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: Priority Health SBD |
$202.89
|
| Rate for Payer: UMR Bronson Commercial |
$119.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna American Axle |
$25.46
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Medicare |
$19.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.46
|
| Rate for Payer: BCBS Complete |
$15.67
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health SBD |
$24.68
|
| Rate for Payer: UMR Bronson Commercial |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$207.39
|
|
|
Service Code
|
NDC 70710100802
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.73 |
| Max. Negotiated Rate |
$186.65 |
| Rate for Payer: Aetna American Axle |
$134.80
|
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna Medicare |
$103.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.80
|
| Rate for Payer: BCBS Complete |
$82.96
|
| Rate for Payer: Cash Price |
$165.91
|
| Rate for Payer: Cofinity Commercial |
$145.17
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.91
|
| Rate for Payer: Healthscope Commercial |
$186.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.28
|
| Rate for Payer: PHP Commercial |
$176.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.80
|
| Rate for Payer: Priority Health SBD |
$130.66
|
| Rate for Payer: UMR Bronson Commercial |
$76.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.54
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna American Axle |
$311.67
|
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.67
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$335.64
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$335.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.59
|
| Rate for Payer: Healthscope Commercial |
$431.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.57
|
| Rate for Payer: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| Rate for Payer: Priority Health SBD |
$302.08
|
| Rate for Payer: UMR Bronson Commercial |
$210.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$273.73
|
|
|
Service Code
|
NDC 69238126401
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.28 |
| Max. Negotiated Rate |
$246.36 |
| Rate for Payer: Aetna American Axle |
$177.92
|
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare |
$136.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.92
|
| Rate for Payer: BCBS Complete |
$109.49
|
| Rate for Payer: Cash Price |
$218.98
|
| Rate for Payer: Cofinity Commercial |
$191.61
|
| Rate for Payer: Cofinity Commercial |
$235.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.98
|
| Rate for Payer: Healthscope Commercial |
$246.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.67
|
| Rate for Payer: PHP Commercial |
$232.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.92
|
| Rate for Payer: Priority Health SBD |
$172.45
|
| Rate for Payer: UMR Bronson Commercial |
$101.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.30
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.93 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna American Axle |
$290.91
|
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Commercial |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$313.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| Rate for Payer: UMR Bronson Commercial |
$196.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.67
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$229.94 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna American Axle |
$339.68
|
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Commercial |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$365.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| Rate for Payer: UMR Bronson Commercial |
$229.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.60 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna American Axle |
$290.91
|
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna Medicare |
$223.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: BCBS Complete |
$179.02
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Commercial |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$313.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| Rate for Payer: UMR Bronson Commercial |
$165.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.67
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna American Axle |
$150.05
|
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna Medicare |
$115.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$161.59
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: Priority Health SBD |
$145.44
|
| Rate for Payer: UMR Bronson Commercial |
$85.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna American Axle |
$339.68
|
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna Medicare |
$261.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: BCBS Complete |
$209.04
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Commercial |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$365.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$365.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| Rate for Payer: UMR Bronson Commercial |
$193.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.57 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna American Axle |
$150.05
|
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.05
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$161.59
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: Priority Health SBD |
$145.44
|
| Rate for Payer: UMR Bronson Commercial |
$101.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$298.37
|
|
|
Service Code
|
NDC 60219126601
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.40 |
| Max. Negotiated Rate |
$268.53 |
| Rate for Payer: Aetna American Axle |
$193.94
|
| Rate for Payer: Aetna Commercial |
$253.61
|
| Rate for Payer: Aetna Medicare |
$149.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$119.35
|
| Rate for Payer: Cash Price |
$238.70
|
| Rate for Payer: Cofinity Commercial |
$208.86
|
| Rate for Payer: Cofinity Commercial |
$256.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.70
|
| Rate for Payer: Healthscope Commercial |
$268.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.61
|
| Rate for Payer: PHP Commercial |
$253.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.94
|
| Rate for Payer: Priority Health SBD |
$187.97
|
| Rate for Payer: UMR Bronson Commercial |
$110.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.78
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$276.21
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.53 |
| Max. Negotiated Rate |
$248.59 |
| Rate for Payer: Aetna American Axle |
$179.54
|
| Rate for Payer: Aetna Commercial |
$234.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.54
|
| Rate for Payer: Cash Price |
$220.97
|
| Rate for Payer: Cofinity Commercial |
$193.35
|
| Rate for Payer: Cofinity Commercial |
$237.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.97
|
| Rate for Payer: Healthscope Commercial |
$248.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.78
|
| Rate for Payer: PHP Commercial |
$234.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.54
|
| Rate for Payer: Priority Health SBD |
$174.01
|
| Rate for Payer: UMR Bronson Commercial |
$121.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.16
|
|
