|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$119.99
|
|
|
Service Code
|
NDC 45963053830
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$107.99 |
| Rate for Payer: Aetna American Axle |
$77.99
|
| Rate for Payer: Aetna Commercial |
$101.99
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.99
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: Cash Price |
$95.99
|
| Rate for Payer: Cofinity Commercial |
$103.19
|
| Rate for Payer: Cofinity Commercial |
$83.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.99
|
| Rate for Payer: Healthscope Commercial |
$107.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.99
|
| Rate for Payer: PHP Commercial |
$101.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.99
|
| Rate for Payer: Priority Health SBD |
$75.59
|
| Rate for Payer: UMR Bronson Commercial |
$44.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.99
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$87.42
|
|
|
Service Code
|
NDC 65862018730
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.35 |
| Max. Negotiated Rate |
$78.68 |
| Rate for Payer: Aetna American Axle |
$56.82
|
| Rate for Payer: Aetna Commercial |
$74.31
|
| Rate for Payer: Aetna Medicare |
$43.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.82
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: Cash Price |
$69.94
|
| Rate for Payer: Cofinity Commercial |
$61.19
|
| Rate for Payer: Cofinity Commercial |
$75.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.94
|
| Rate for Payer: Healthscope Commercial |
$78.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.31
|
| Rate for Payer: PHP Commercial |
$74.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.82
|
| Rate for Payer: Priority Health SBD |
$55.07
|
| Rate for Payer: UMR Bronson Commercial |
$32.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.56
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$87.42
|
|
|
Service Code
|
NDC 65862018730
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.46 |
| Max. Negotiated Rate |
$78.68 |
| Rate for Payer: Aetna American Axle |
$56.82
|
| Rate for Payer: Aetna Commercial |
$74.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.82
|
| Rate for Payer: Cash Price |
$69.94
|
| Rate for Payer: Cofinity Commercial |
$61.19
|
| Rate for Payer: Cofinity Commercial |
$75.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.94
|
| Rate for Payer: Healthscope Commercial |
$78.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.31
|
| Rate for Payer: PHP Commercial |
$74.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.82
|
| Rate for Payer: Priority Health SBD |
$55.07
|
| Rate for Payer: UMR Bronson Commercial |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.56
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
NDC 00904655161
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna American Axle |
$185.25
|
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$199.50
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$199.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health SBD |
$179.55
|
| Rate for Payer: UMR Bronson Commercial |
$125.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
OP
|
$120.56
|
|
|
Service Code
|
NDC 65862018830
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.61 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna American Axle |
$78.36
|
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna Medicare |
$60.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.36
|
| Rate for Payer: BCBS Complete |
$48.22
|
| Rate for Payer: Cash Price |
$96.45
|
| Rate for Payer: Cofinity Commercial |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$84.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.45
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.48
|
| Rate for Payer: PHP Commercial |
$102.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.36
|
| Rate for Payer: Priority Health SBD |
$75.95
|
| Rate for Payer: UMR Bronson Commercial |
$44.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.42
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
OP
|
$141.36
|
|
|
Service Code
|
NDC 45963053930
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$127.22 |
| Rate for Payer: Aetna American Axle |
$91.88
|
| Rate for Payer: Aetna Commercial |
$120.16
|
| Rate for Payer: Aetna Medicare |
$70.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.88
|
| Rate for Payer: BCBS Complete |
$56.54
|
| Rate for Payer: Cash Price |
$113.09
|
| Rate for Payer: Cofinity Commercial |
$121.57
|
| Rate for Payer: Cofinity Commercial |
$98.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.09
|
| Rate for Payer: Healthscope Commercial |
$127.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.16
|
| Rate for Payer: PHP Commercial |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.88
|
| Rate for Payer: Priority Health SBD |
$89.06
|
| Rate for Payer: UMR Bronson Commercial |
$52.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.02
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
IP
|
$120.56
|
|
|
Service Code
|
NDC 65862018830
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna American Axle |
$78.36
|
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.36
|
| Rate for Payer: Cash Price |
$96.45
|
| Rate for Payer: Cofinity Commercial |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$84.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.45
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.48
|
| Rate for Payer: PHP Commercial |
$102.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.36
|
| Rate for Payer: Priority Health SBD |
$75.95
|
| Rate for Payer: UMR Bronson Commercial |
$53.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.42
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
OP
|
$141.65
|
|
|
Service Code
|
NDC 63304045930
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.41 |
| Max. Negotiated Rate |
$127.48 |
| Rate for Payer: Aetna American Axle |
$92.07
|
| Rate for Payer: Aetna Commercial |
$120.40
|
| Rate for Payer: Aetna Medicare |
$70.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.07
|
| Rate for Payer: BCBS Complete |
$56.66
|
| Rate for Payer: Cash Price |
$113.32
|
| Rate for Payer: Cofinity Commercial |
$121.82
|
| Rate for Payer: Cofinity Commercial |
$99.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.32
|
| Rate for Payer: Healthscope Commercial |
$127.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.40
|
| Rate for Payer: PHP Commercial |
$120.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.07
|
| Rate for Payer: Priority Health SBD |
$89.24
|
| Rate for Payer: UMR Bronson Commercial |
$52.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.24
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
IP
|
$141.65
|
|
|
Service Code
|
NDC 63304045930
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.33 |
| Max. Negotiated Rate |
$127.48 |
| Rate for Payer: Aetna American Axle |
$92.07
|
| Rate for Payer: Aetna Commercial |
$120.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.07
|
| Rate for Payer: Cash Price |
$113.32
|
| Rate for Payer: Cofinity Commercial |
$121.82
|
| Rate for Payer: Cofinity Commercial |
$99.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.32
|
| Rate for Payer: Healthscope Commercial |
$127.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.40
|
| Rate for Payer: PHP Commercial |
$120.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.07
|
| Rate for Payer: Priority Health SBD |
$89.24
|
| Rate for Payer: UMR Bronson Commercial |
$62.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.24
|
|
|
ONDANSETRON HCL 8 MG TABLET
|
Facility
|
IP
|
$141.36
|
|
|
Service Code
|
NDC 45963053930
|
| Hospital Charge Code |
10779
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$127.22 |
| Rate for Payer: Aetna American Axle |
$91.88
|
| Rate for Payer: Aetna Commercial |
$120.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.88
|
| Rate for Payer: Cash Price |
$113.09
|
| Rate for Payer: Cofinity Commercial |
$121.57
|
| Rate for Payer: Cofinity Commercial |
$98.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.09
|
| Rate for Payer: Healthscope Commercial |
$127.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.16
|
| Rate for Payer: PHP Commercial |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.88
|
| Rate for Payer: Priority Health SBD |
$89.06
|
| Rate for Payer: UMR Bronson Commercial |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.02
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
IP
|
$9.10
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$8.19 |
| Rate for Payer: Aetna American Axle |
$5.92
|
| Rate for Payer: Aetna American Axle |
$6.04
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.04
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.51
|
| Rate for Payer: Cofinity Commercial |
$6.37
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$7.90
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health SBD |
$5.73
|
| Rate for Payer: Priority Health SBD |
$5.86
|
| Rate for Payer: UMR Bronson Commercial |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$4.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.98
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
OP
|
$9.10
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$8.19 |
| Rate for Payer: Aetna American Axle |
$5.92
|
| Rate for Payer: Aetna American Axle |
$6.04
|
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna Medicare |
$4.55
|
| Rate for Payer: Aetna Medicare |
$4.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.04
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.37
|
| Rate for Payer: Cofinity Commercial |
$6.51
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.90
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health SBD |
$5.86
|
| Rate for Payer: Priority Health SBD |
$5.73
|
| Rate for Payer: UMR Bronson Commercial |
$3.37
|
| Rate for Payer: UMR Bronson Commercial |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.82
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
OP
|
$9.10
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$8.19 |
| Rate for Payer: Aetna American Axle |
$5.92
|
| Rate for Payer: Aetna American Axle |
$11.24
|
| Rate for Payer: Aetna American Axle |
$11.38
|
| Rate for Payer: Aetna American Axle |
$7.54
|
| Rate for Payer: Aetna American Axle |
$6.04
|
| Rate for Payer: Aetna American Axle |
$6.34
|
| Rate for Payer: Aetna American Axle |
$6.79
|
| Rate for Payer: Aetna American Axle |
$6.96
|
| Rate for Payer: Aetna American Axle |
$7.02
|
| Rate for Payer: Aetna American Axle |
$10.03
|
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Commercial |
$8.29
|
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Commercial |
$14.88
|
| Rate for Payer: Aetna Commercial |
$9.10
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Commercial |
$9.18
|
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna Medicare |
$5.40
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Aetna Medicare |
$8.64
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna Medicare |
$4.88
|
| Rate for Payer: Aetna Medicare |
$5.35
|
| Rate for Payer: Aetna Medicare |
$4.65
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Aetna Medicare |
$4.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.38
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS Complete |
$4.28
|
| Rate for Payer: BCBS Complete |
$3.90
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$9.20
|
| Rate for Payer: Cofinity Commercial |
$7.32
|
| Rate for Payer: Cofinity Commercial |
$8.99
|
| Rate for Payer: Cofinity Commercial |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$7.56
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Commercial |
$8.12
|
| Rate for Payer: Cofinity Commercial |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.80
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$12.25
|
| Rate for Payer: Cofinity Commercial |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$6.37
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$6.51
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.82
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.64
|
| Rate for Payer: Healthscope Commercial |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$9.63
|
| Rate for Payer: Healthscope Commercial |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$13.89
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Healthscope Commercial |
$8.78
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$15.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$14.88
|
| Rate for Payer: PHP Commercial |
$9.86
|
| Rate for Payer: PHP Commercial |
$7.90
|
| Rate for Payer: PHP Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$9.10
|
| Rate for Payer: PHP Commercial |
$8.88
|
| Rate for Payer: PHP Commercial |
$9.18
|
| Rate for Payer: PHP Commercial |
$8.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.02
|
| Rate for Payer: Priority Health SBD |
$5.86
|
| Rate for Payer: Priority Health SBD |
$5.73
|
| Rate for Payer: Priority Health SBD |
$9.72
|
| Rate for Payer: Priority Health SBD |
$6.74
|
| Rate for Payer: Priority Health SBD |
$6.80
|
| Rate for Payer: Priority Health SBD |
$6.58
|
| Rate for Payer: Priority Health SBD |
$6.14
|
| Rate for Payer: Priority Health SBD |
$11.02
|
| Rate for Payer: Priority Health SBD |
$10.89
|
| Rate for Payer: Priority Health SBD |
$7.31
|
| Rate for Payer: UMR Bronson Commercial |
$3.87
|
| Rate for Payer: UMR Bronson Commercial |
$3.37
|
| Rate for Payer: UMR Bronson Commercial |
$4.29
|
| Rate for Payer: UMR Bronson Commercial |
$3.44
|
| Rate for Payer: UMR Bronson Commercial |
$3.61
|
| Rate for Payer: UMR Bronson Commercial |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$6.40
|
| Rate for Payer: UMR Bronson Commercial |
$3.96
|
| Rate for Payer: UMR Bronson Commercial |
$5.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.02
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
IP
|
$11.60
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$10.44 |
| Rate for Payer: Aetna American Axle |
$7.54
|
| Rate for Payer: Aetna American Axle |
$6.34
|
| Rate for Payer: Aetna American Axle |
$7.02
|
| Rate for Payer: Aetna American Axle |
$6.04
|
| Rate for Payer: Aetna American Axle |
$11.24
|
| Rate for Payer: Aetna American Axle |
$5.92
|
| Rate for Payer: Aetna American Axle |
$11.38
|
| Rate for Payer: Aetna American Axle |
$6.79
|
| Rate for Payer: Aetna American Axle |
$6.96
|
| Rate for Payer: Aetna Commercial |
$8.29
|
| Rate for Payer: Aetna Commercial |
$9.10
|
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Commercial |
$9.18
|
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Aetna Commercial |
$14.88
|
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.24
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Commercial |
$7.32
|
| Rate for Payer: Cofinity Commercial |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$8.12
|
| Rate for Payer: Cofinity Commercial |
$7.56
|
| Rate for Payer: Cofinity Commercial |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$9.20
|
| Rate for Payer: Cofinity Commercial |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$8.99
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Cofinity Commercial |
$6.82
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.51
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$6.37
|
| Rate for Payer: Cofinity Commercial |
$12.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.28
|
| Rate for Payer: Healthscope Commercial |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$8.78
|
| Rate for Payer: Healthscope Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$15.75
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Healthscope Commercial |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$9.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Commercial |
$7.90
|
| Rate for Payer: PHP Commercial |
$8.29
|
| Rate for Payer: PHP Commercial |
$14.88
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$9.18
|
| Rate for Payer: PHP Commercial |
$9.86
|
| Rate for Payer: PHP Commercial |
$8.88
|
| Rate for Payer: PHP Commercial |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.34
|
| Rate for Payer: Priority Health SBD |
$6.58
|
| Rate for Payer: Priority Health SBD |
$10.89
|
| Rate for Payer: Priority Health SBD |
$7.31
|
| Rate for Payer: Priority Health SBD |
$6.14
|
| Rate for Payer: Priority Health SBD |
$5.73
|
| Rate for Payer: Priority Health SBD |
$6.80
|
| Rate for Payer: Priority Health SBD |
$6.74
|
| Rate for Payer: Priority Health SBD |
$11.02
|
| Rate for Payer: Priority Health SBD |
$5.86
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: UMR Bronson Commercial |
$4.09
|
| Rate for Payer: UMR Bronson Commercial |
$4.29
|
| Rate for Payer: UMR Bronson Commercial |
$4.71
|
| Rate for Payer: UMR Bronson Commercial |
$4.75
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
| Rate for Payer: UMR Bronson Commercial |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$5.10
|
| Rate for Payer: UMR Bronson Commercial |
$7.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.82
|
|
|
OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR BILATERAL;
|
Facility
|
OP
|
$5,042.00
|
|
|
Service Code
|
CPT 58940
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$538.48 |
| Max. Negotiated Rate |
$5,042.00 |
| Rate for Payer: BCBS Trust/PPO |
$1,900.27
|
| Rate for Payer: BCN Commercial |
$1,900.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$592.33
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Exchange |
$538.48
|
|
|
OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY
|
Facility
|
OP
|
$93,841.38
|
|
|
Service Code
|
CPT 64582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$807.93 |
| Max. Negotiated Rate |
$93,841.38 |
| Rate for Payer: Aetna Medicare |
$31,051.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,321.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,321.76
|
| Rate for Payer: BCBS Complete |
$16,803.75
|
| Rate for Payer: BCBS MAPPO |
$29,857.41
|
| Rate for Payer: BCBS Trust/PPO |
$40,939.59
|
| Rate for Payer: BCN Commercial |
$40,939.59
|
| Rate for Payer: BCN Medicare Advantage |
$29,857.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,857.41
|
| Rate for Payer: Mclaren Medicaid |
$16,003.57
|
| Rate for Payer: Mclaren Medicare |
$29,857.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,350.28
|
| Rate for Payer: Meridian Medicaid |
$16,803.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,336.02
|
| Rate for Payer: Nomi Health Commercial |
$62,700.56
|
| Rate for Payer: PACE Medicare |
$28,364.54
|
| Rate for Payer: PACE SWMI |
$29,857.41
|
| Rate for Payer: PHP Medicare Advantage |
$29,857.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,003.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93,841.38
|
| Rate for Payer: Priority Health Medicare |
$29,857.41
|
| Rate for Payer: Priority Health Narrow Network |
$75,073.10
|
| Rate for Payer: Railroad Medicare Medicare |
$29,857.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$888.72
|
| Rate for Payer: UHC Core |
$30,600.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,857.41
|
| Rate for Payer: UHC Exchange |
$807.93
|
| Rate for Payer: UHC Medicare Advantage |
$29,857.41
|
| Rate for Payer: UHCCP Medicaid |
$16,003.57
|
| Rate for Payer: VA VA |
$29,857.41
|
|
|
OPEN IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; SACRAL NERVE (TRANSFORAMINAL PLACEMENT)
|
Facility
|
OP
|
$20,210.02
|
|
|
Service Code
|
CPT 64581
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$635.23 |
| Max. Negotiated Rate |
$20,210.02 |
| Rate for Payer: Aetna Medicare |
$6,687.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,037.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,037.75
|
| Rate for Payer: BCBS Complete |
$3,618.92
|
| Rate for Payer: BCBS MAPPO |
$6,430.20
|
| Rate for Payer: BCBS Trust/PPO |
$12,381.59
|
| Rate for Payer: BCN Commercial |
$12,381.59
|
| Rate for Payer: BCN Medicare Advantage |
$6,430.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,430.20
|
| Rate for Payer: Mclaren Medicaid |
$3,446.59
|
| Rate for Payer: Mclaren Medicare |
$6,430.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,751.71
|
| Rate for Payer: Meridian Medicaid |
$3,618.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,394.73
|
| Rate for Payer: Nomi Health Commercial |
$13,503.42
|
| Rate for Payer: PACE Medicare |
$6,108.69
|
| Rate for Payer: PACE SWMI |
$6,430.20
|
| Rate for Payer: PHP Medicare Advantage |
$6,430.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,446.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,210.02
|
| Rate for Payer: Priority Health Medicare |
$6,430.20
|
| Rate for Payer: Priority Health Narrow Network |
$16,168.02
|
| Rate for Payer: Railroad Medicare Medicare |
$6,430.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.75
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,430.20
|
| Rate for Payer: UHC Exchange |
$635.23
|
| Rate for Payer: UHC Medicare Advantage |
$6,430.20
|
| Rate for Payer: UHCCP Medicaid |
$3,446.59
|
| Rate for Payer: VA VA |
$6,430.20
|
|
|
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 23550
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$556.20 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,814.60
|
| Rate for Payer: BCN Commercial |
$4,814.60
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.82
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$556.20
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 23552
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$630.71 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,814.60
|
| Rate for Payer: BCN Commercial |
$4,814.60
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.78
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$630.71
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
OPEN TREATMENT OF ACUTE OR CHRONIC ELBOW DISLOCATION
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 24615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$693.07 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,369.36
|
| Rate for Payer: BCN Commercial |
$5,369.36
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.38
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$693.07
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 23660
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$568.89 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,126.82
|
| Rate for Payer: BCN Commercial |
$4,126.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.78
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$568.89
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES PUBIC SYMPHYSIS AND/OR IPSILATERAL SUPERIOR/INFERIOR RAMI)
|
Facility
|
OP
|
$3,153.61
|
|
|
Service Code
|
CPT 27217
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,014.00 |
| Max. Negotiated Rate |
$3,153.61 |
| Rate for Payer: BCBS Trust/PPO |
$3,153.61
|
| Rate for Payer: BCN Commercial |
$3,153.61
|
| Rate for Payer: UHC Core |
$2,014.00
|
|
|
OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, INCLUDES INTERNAL FIXATION WHEN PERFORMED (INCLUDES PUBIC SYMPHYSIS AND/OR SUPERIOR/INFERIOR RAMI)
|
Facility
|
OP
|
$8,596.00
|
|
|
Service Code
|
CPT G0414
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$972.58 |
| Max. Negotiated Rate |
$8,596.00 |
| Rate for Payer: BCBS Trust/PPO |
$3,560.47
|
| Rate for Payer: BCN Commercial |
$3,560.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.84
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$972.58
|
|
|
OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 26746
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$718.20 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.78
|
| Rate for Payer: BCN Commercial |
$2,214.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$790.02
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$718.20
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATERAL AND POSTERIOR MALLEOLI, OR MEDIAL AND POSTERIOR MALLEOLI), INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$21,998.64
|
|
|
Service Code
|
CPT 27814
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$740.21 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,808.58
|
| Rate for Payer: BCN Commercial |
$5,808.58
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.23
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Exchange |
$740.21
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,751.61
|
| Rate for Payer: VA VA |
$6,999.28
|
|
