|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$5,812.33
|
|
|
Service Code
|
APR-DRG 7212
|
| Min. Negotiated Rate |
$5,535.55 |
| Max. Negotiated Rate |
$5,812.33 |
| Rate for Payer: BCBS Complete |
$5,812.33
|
| Rate for Payer: Mclaren Medicaid |
$5,535.55
|
| Rate for Payer: Meridian Medicaid |
$5,812.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,535.55
|
| Rate for Payer: UHC Medicaid |
$5,535.55
|
| Rate for Payer: UHCCP Medicaid |
$5,535.55
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$9,891.01
|
|
|
Service Code
|
APR-DRG 7213
|
| Min. Negotiated Rate |
$9,420.01 |
| Max. Negotiated Rate |
$9,891.01 |
| Rate for Payer: BCBS Complete |
$9,891.01
|
| Rate for Payer: Mclaren Medicaid |
$9,420.01
|
| Rate for Payer: Meridian Medicaid |
$9,891.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,420.01
|
| Rate for Payer: UHC Medicaid |
$9,420.01
|
| Rate for Payer: UHCCP Medicaid |
$9,420.01
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES
|
Facility
|
IP
|
$32,663.94
|
|
|
Service Code
|
MSDRG 769
|
| Min. Negotiated Rate |
$13,988.04 |
| Max. Negotiated Rate |
$32,663.94 |
| Rate for Payer: Aetna Medicare |
$15,313.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,405.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,405.31
|
| Rate for Payer: BCBS MAPPO |
$14,724.25
|
| Rate for Payer: BCBS Trust/PPO |
$32,663.94
|
| Rate for Payer: BCN Commercial |
$32,663.94
|
| Rate for Payer: BCN Medicare Advantage |
$14,724.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,724.25
|
| Rate for Payer: Mclaren Medicare |
$14,724.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,460.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,932.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,196.67
|
| Rate for Payer: Nomi Health Commercial |
$21,798.42
|
| Rate for Payer: PACE Medicare |
$13,988.04
|
| Rate for Payer: PACE SWMI |
$14,724.25
|
| Rate for Payer: PHP Medicare Advantage |
$14,724.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,834.64
|
| Rate for Payer: Priority Health Medicare |
$14,724.25
|
| Rate for Payer: Priority Health Tiered Network |
$16,667.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14,724.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,543.74
|
| Rate for Payer: UHC Core |
$23,043.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,724.25
|
| Rate for Payer: UHC Exchange |
$18,819.30
|
| Rate for Payer: VA VA |
$14,724.25
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES
|
Facility
|
IP
|
$10,671.61
|
|
|
Service Code
|
MSDRG 776
|
| Min. Negotiated Rate |
$5,764.63 |
| Max. Negotiated Rate |
$10,671.61 |
| Rate for Payer: Aetna Medicare |
$6,310.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,585.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,585.04
|
| Rate for Payer: BCBS MAPPO |
$6,068.03
|
| Rate for Payer: BCBS Trust/PPO |
$8,957.26
|
| Rate for Payer: BCN Commercial |
$8,957.26
|
| Rate for Payer: BCN Medicare Advantage |
$6,068.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,068.03
|
| Rate for Payer: Mclaren Medicare |
$6,068.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,371.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,978.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,674.83
|
| Rate for Payer: Nomi Health Commercial |
$8,445.63
|
| Rate for Payer: PACE Medicare |
$5,764.63
|
| Rate for Payer: PACE SWMI |
$6,068.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,068.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,982.83
|
| Rate for Payer: Priority Health Medicare |
$6,068.03
|
| Rate for Payer: Priority Health Tiered Network |
$7,986.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,068.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,671.61
|
| Rate for Payer: UHC Core |
$8,928.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,068.03
|
| Rate for Payer: UHC Exchange |
$7,291.39
|
| Rate for Payer: VA VA |
$6,068.03
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$10,476.36
|
|
|
Service Code
|
APR-DRG 5614
|
| Min. Negotiated Rate |
$9,977.49 |
| Max. Negotiated Rate |
$10,476.36 |
| Rate for Payer: BCBS Complete |
$10,476.36
|
| Rate for Payer: Mclaren Medicaid |
$9,977.49
|
| Rate for Payer: Meridian Medicaid |
$10,476.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,977.49
|
| Rate for Payer: UHC Medicaid |
$9,977.49
|
| Rate for Payer: UHCCP Medicaid |
$9,977.49
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$5,197.32
|
|
|
Service Code
|
APR-DRG 5613
|
| Min. Negotiated Rate |
$4,949.83 |
| Max. Negotiated Rate |
$5,197.32 |
| Rate for Payer: BCBS Complete |
$5,197.32
|
| Rate for Payer: Mclaren Medicaid |
$4,949.83
|
| Rate for Payer: Meridian Medicaid |
$5,197.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,949.83
|
| Rate for Payer: UHC Medicaid |
$4,949.83
|
| Rate for Payer: UHCCP Medicaid |
$4,949.83
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$1,819.00
|
|
|
Service Code
|
APR-DRG 5611
|
| Min. Negotiated Rate |
$1,732.38 |
| Max. Negotiated Rate |
$1,819.00 |
| Rate for Payer: BCBS Complete |
$1,819.00
|
| Rate for Payer: Mclaren Medicaid |
$1,732.38
|
| Rate for Payer: Meridian Medicaid |
$1,819.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,732.38
|
| Rate for Payer: UHC Medicaid |
$1,732.38
|
| Rate for Payer: UHCCP Medicaid |
$1,732.38
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$2,894.66
|
|
|
Service Code
|
APR-DRG 5612
|
| Min. Negotiated Rate |
$2,756.82 |
| Max. Negotiated Rate |
$2,894.66 |
| Rate for Payer: BCBS Complete |
$2,894.66
|
| Rate for Payer: Mclaren Medicaid |
$2,756.82
|
| Rate for Payer: Meridian Medicaid |
$2,894.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,756.82
|
| Rate for Payer: UHC Medicaid |
$2,756.82
|
| Rate for Payer: UHCCP Medicaid |
$2,756.82
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$5,999.98
|
|
|
Service Code
|
APR-DRG 5482
|
| Min. Negotiated Rate |
$5,714.27 |
| Max. Negotiated Rate |
$5,999.98 |
| Rate for Payer: BCBS Complete |
$5,999.98
|
| Rate for Payer: Mclaren Medicaid |
$5,714.27
|
| Rate for Payer: Meridian Medicaid |
$5,999.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,714.27
|
| Rate for Payer: UHC Medicaid |
$5,714.27
|
| Rate for Payer: UHCCP Medicaid |
$5,714.27
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$2,420.09
|
|
|
Service Code
|
APR-DRG 5481
|
| Min. Negotiated Rate |
$2,304.85 |
| Max. Negotiated Rate |
$2,420.09 |
| Rate for Payer: BCBS Complete |
$2,420.09
|
| Rate for Payer: Mclaren Medicaid |
$2,304.85
|
| Rate for Payer: Meridian Medicaid |
$2,420.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,304.85
|
| Rate for Payer: UHC Medicaid |
$2,304.85
|
| Rate for Payer: UHCCP Medicaid |
$2,304.85
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$9,647.06
|
|
|
Service Code
|
APR-DRG 5483
|
| Min. Negotiated Rate |
$9,187.68 |
| Max. Negotiated Rate |
$9,647.06 |
| Rate for Payer: BCBS Complete |
$9,647.06
|
| Rate for Payer: Mclaren Medicaid |
$9,187.68
|
| Rate for Payer: Meridian Medicaid |
$9,647.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,187.68
|
| Rate for Payer: UHC Medicaid |
$9,187.68
|
| Rate for Payer: UHCCP Medicaid |
$9,187.68
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$17,936.99
|
|
|
Service Code
|
APR-DRG 5484
|
| Min. Negotiated Rate |
$17,082.85 |
| Max. Negotiated Rate |
$17,936.99 |
| Rate for Payer: BCBS Complete |
$17,936.99
|
| Rate for Payer: Mclaren Medicaid |
$17,082.85
|
| Rate for Payer: Meridian Medicaid |
$17,936.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,082.85
|
| Rate for Payer: UHC Medicaid |
$17,082.85
|
| Rate for Payer: UHCCP Medicaid |
$17,082.85
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
IP
|
$1,289.40
|
|
|
Service Code
|
NDC 60258000216
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$567.34 |
| Max. Negotiated Rate |
$1,160.46 |
| Rate for Payer: Aetna American Axle |
$838.11
|
| Rate for Payer: Aetna Commercial |
$1,095.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.11
|
| Rate for Payer: Cash Price |
$1,031.52
|
| Rate for Payer: Cofinity Advantage |
$902.58
|
| Rate for Payer: Cofinity Commercial |
$1,108.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.52
|
| Rate for Payer: Healthscope Commercial |
$1,160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.05
|
| Rate for Payer: PHP Commercial |
$1,095.99
|
| Rate for Payer: Priority Health SBD |
$812.32
|
| Rate for Payer: UMR Bronson Commercial |
$567.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.05
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
IP
|
$311.24
|
|
|
Service Code
|
NDC 00121067716
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.95 |
| Max. Negotiated Rate |
$280.12 |
| Rate for Payer: Aetna American Axle |
$202.31
|
| Rate for Payer: Aetna Commercial |
$264.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.31
|
| Rate for Payer: Cash Price |
$248.99
|
| Rate for Payer: Cofinity Advantage |
$217.87
|
| Rate for Payer: Cofinity Commercial |
$267.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.99
|
| Rate for Payer: Healthscope Commercial |
$280.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.43
|
| Rate for Payer: PHP Commercial |
$264.55
|
| Rate for Payer: Priority Health SBD |
$196.08
|
| Rate for Payer: UMR Bronson Commercial |
$136.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.43
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
OP
|
$311.24
|
|
|
Service Code
|
NDC 00121067716
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.16 |
| Max. Negotiated Rate |
$280.12 |
| Rate for Payer: Aetna American Axle |
$202.31
|
| Rate for Payer: Aetna Commercial |
$264.55
|
| Rate for Payer: Aetna Medicare |
$155.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.31
|
| Rate for Payer: BCBS Complete |
$124.50
|
| Rate for Payer: Cash Price |
$248.99
|
| Rate for Payer: Cofinity Advantage |
$217.87
|
| Rate for Payer: Cofinity Commercial |
$267.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.99
|
| Rate for Payer: Healthscope Commercial |
$280.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.43
|
| Rate for Payer: PHP Commercial |
$264.55
|
| Rate for Payer: Priority Health SBD |
$196.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.31
|
| Rate for Payer: UHC Core |
$162.16
|
| Rate for Payer: UHC Exchange |
$122.32
|
| Rate for Payer: UMR Bronson Commercial |
$115.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.43
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
OP
|
$1,289.40
|
|
|
Service Code
|
NDC 60258000216
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$477.08 |
| Max. Negotiated Rate |
$1,160.46 |
| Rate for Payer: Aetna American Axle |
$838.11
|
| Rate for Payer: Aetna Commercial |
$1,095.99
|
| Rate for Payer: Aetna Medicare |
$644.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.11
|
| Rate for Payer: BCBS Complete |
$515.76
|
| Rate for Payer: Cash Price |
$1,031.52
|
| Rate for Payer: Cofinity Advantage |
$902.58
|
| Rate for Payer: Cofinity Commercial |
$1,108.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.52
|
| Rate for Payer: Healthscope Commercial |
$1,160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,031.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.05
|
| Rate for Payer: PHP Commercial |
$1,095.99
|
| Rate for Payer: Priority Health SBD |
$812.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.11
|
| Rate for Payer: UHC Core |
$671.78
|
| Rate for Payer: UHC Exchange |
$506.73
|
| Rate for Payer: UMR Bronson Commercial |
$477.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.05
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
IP
|
$1,289.40
|
|
|
Service Code
|
NDC 58657031116
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$567.34 |
| Max. Negotiated Rate |
$1,160.46 |
| Rate for Payer: Aetna American Axle |
$838.11
|
| Rate for Payer: Aetna Commercial |
$1,095.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.11
|
| Rate for Payer: Cash Price |
$1,031.52
|
| Rate for Payer: Cofinity Advantage |
$902.58
|
| Rate for Payer: Cofinity Commercial |
$1,108.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.52
|
| Rate for Payer: Healthscope Commercial |
$1,160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.05
|
| Rate for Payer: PHP Commercial |
$1,095.99
|
| Rate for Payer: Priority Health SBD |
$812.32
|
| Rate for Payer: UMR Bronson Commercial |
$567.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.05
|
|
|
POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN
|
Facility
|
OP
|
$1,289.40
|
|
|
Service Code
|
NDC 58657031116
|
| Hospital Charge Code |
11057
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$477.08 |
| Max. Negotiated Rate |
$1,160.46 |
| Rate for Payer: Aetna American Axle |
$838.11
|
| Rate for Payer: Aetna Commercial |
$1,095.99
|
| Rate for Payer: Aetna Medicare |
$644.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.11
|
| Rate for Payer: BCBS Complete |
$515.76
|
| Rate for Payer: Cash Price |
$1,031.52
|
| Rate for Payer: Cofinity Advantage |
$902.58
|
| Rate for Payer: Cofinity Commercial |
$1,108.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.52
|
| Rate for Payer: Healthscope Commercial |
$1,160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,031.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.05
|
| Rate for Payer: PHP Commercial |
$1,095.99
|
| Rate for Payer: Priority Health SBD |
$812.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.11
|
| Rate for Payer: UHC Core |
$671.78
|
| Rate for Payer: UHC Exchange |
$506.73
|
| Rate for Payer: UMR Bronson Commercial |
$477.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.05
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$40.50
|
|
|
Service Code
|
NDC 00409329425
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$36.45 |
| Rate for Payer: Aetna American Axle |
$26.32
|
| Rate for Payer: Aetna Commercial |
$34.42
|
| Rate for Payer: Aetna Medicare |
$20.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.32
|
| Rate for Payer: BCBS Complete |
$16.20
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cofinity Advantage |
$28.35
|
| Rate for Payer: Cofinity Commercial |
$34.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.40
|
| Rate for Payer: Healthscope Commercial |
$36.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.38
|
| Rate for Payer: PHP Commercial |
$34.42
|
| Rate for Payer: Priority Health SBD |
$25.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.32
|
| Rate for Payer: UHC Core |
$21.10
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UMR Bronson Commercial |
$14.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.38
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.92
|
|
|
Service Code
|
NDC 00409329461
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.96 |
| Max. Negotiated Rate |
$22.43 |
| Rate for Payer: Aetna American Axle |
$16.20
|
| Rate for Payer: Aetna Commercial |
$21.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.20
|
| Rate for Payer: Cash Price |
$19.94
|
| Rate for Payer: Cofinity Advantage |
$17.44
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.94
|
| Rate for Payer: Healthscope Commercial |
$22.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.69
|
| Rate for Payer: PHP Commercial |
$21.18
|
| Rate for Payer: Priority Health SBD |
$15.70
|
| Rate for Payer: UMR Bronson Commercial |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.69
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.76
|
|
|
Service Code
|
NDC 00409818315
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna American Axle |
$14.14
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Medicare |
$10.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.14
|
| Rate for Payer: BCBS Complete |
$8.70
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cofinity Advantage |
$15.23
|
| Rate for Payer: Cofinity Commercial |
$18.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.41
|
| Rate for Payer: Healthscope Commercial |
$19.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.32
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: Priority Health SBD |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.14
|
| Rate for Payer: UHC Core |
$11.34
|
| Rate for Payer: UHC Exchange |
$8.55
|
| Rate for Payer: UMR Bronson Commercial |
$8.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.32
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.92
|
|
|
Service Code
|
NDC 00409329451
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$22.43 |
| Rate for Payer: Aetna American Axle |
$16.20
|
| Rate for Payer: Aetna Commercial |
$21.18
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.20
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: Cash Price |
$19.94
|
| Rate for Payer: Cofinity Advantage |
$17.44
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.94
|
| Rate for Payer: Healthscope Commercial |
$22.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.69
|
| Rate for Payer: PHP Commercial |
$21.18
|
| Rate for Payer: Priority Health SBD |
$15.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.20
|
| Rate for Payer: UHC Core |
$12.98
|
| Rate for Payer: UHC Exchange |
$9.79
|
| Rate for Payer: UMR Bronson Commercial |
$9.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.69
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$40.50
|
|
|
Service Code
|
NDC 00409329425
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.82 |
| Max. Negotiated Rate |
$36.45 |
| Rate for Payer: Aetna American Axle |
$26.32
|
| Rate for Payer: Aetna Commercial |
$34.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.32
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cofinity Advantage |
$28.35
|
| Rate for Payer: Cofinity Commercial |
$34.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.40
|
| Rate for Payer: Healthscope Commercial |
$36.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.38
|
| Rate for Payer: PHP Commercial |
$34.42
|
| Rate for Payer: Priority Health SBD |
$25.52
|
| Rate for Payer: UMR Bronson Commercial |
$17.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.38
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.32
|
|
|
Service Code
|
NDC 51754200401
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.70 |
| Max. Negotiated Rate |
$66.89 |
| Rate for Payer: Aetna American Axle |
$48.31
|
| Rate for Payer: Aetna Commercial |
$63.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.31
|
| Rate for Payer: Cash Price |
$59.46
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.46
|
| Rate for Payer: Healthscope Commercial |
$66.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.74
|
| Rate for Payer: PHP Commercial |
$63.17
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UMR Bronson Commercial |
$32.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.74
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.05
|
|
|
Service Code
|
NDC 51754200104
|
| Hospital Charge Code |
6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna American Axle |
$12.38
|
| Rate for Payer: Aetna Commercial |
$16.19
|
| Rate for Payer: Aetna Medicare |
$9.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.38
|
| Rate for Payer: BCBS Complete |
$7.62
|
| Rate for Payer: Cash Price |
$15.24
|
| Rate for Payer: Cofinity Advantage |
$13.34
|
| Rate for Payer: Cofinity Commercial |
$16.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.24
|
| Rate for Payer: Healthscope Commercial |
$17.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.29
|
| Rate for Payer: PHP Commercial |
$16.19
|
| Rate for Payer: Priority Health SBD |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$9.93
|
| Rate for Payer: UHC Exchange |
$7.49
|
| Rate for Payer: UMR Bronson Commercial |
$7.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.29
|
|
