|
PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$8,255.24
|
|
|
Service Code
|
HCPCS Q5111
|
| Hospital Charge Code |
189200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$71.07 |
| Max. Negotiated Rate |
$8,255.24 |
| Rate for Payer: Aetna Commercial |
$7,429.71
|
| Rate for Payer: Aetna Medicare |
$135.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.86
|
| Rate for Payer: ASR ASR |
$8,007.58
|
| Rate for Payer: BCBS Complete |
$74.63
|
| Rate for Payer: BCBS MAPPO |
$135.89
|
| Rate for Payer: BCBS Trust/PPO |
$6,806.44
|
| Rate for Payer: BCN Commercial |
$6,806.44
|
| Rate for Payer: BCN Medicare Advantage |
$135.89
|
| Rate for Payer: Cash Price |
$6,604.19
|
| Rate for Payer: Cash Price |
$6,604.19
|
| Rate for Payer: Cofinity Commercial |
$7,759.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,604.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.89
|
| Rate for Payer: Healthscope Commercial |
$8,007.58
|
| Rate for Payer: Healthscope Whirlpool |
$8,255.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$135.89
|
| Rate for Payer: Mclaren Commercial |
$7,429.71
|
| Rate for Payer: Mclaren Medicaid |
$135.89
|
| Rate for Payer: Mclaren Medicare |
$135.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.68
|
| Rate for Payer: Meridian Medicaid |
$74.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,016.95
|
| Rate for Payer: Nomi Health Commercial |
$6,769.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,191.43
|
| Rate for Payer: PACE Medicare |
$129.10
|
| Rate for Payer: PACE SWMI |
$135.89
|
| Rate for Payer: PHP Commercial |
$149.48
|
| Rate for Payer: PHP Medicaid |
$72.84
|
| Rate for Payer: PHP Medicare Advantage |
$135.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$168.10
|
| Rate for Payer: Priority Health Medicare |
$135.89
|
| Rate for Payer: Priority Health Narrow Network |
$134.48
|
| Rate for Payer: Railroad Medicare Medicare |
$135.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,264.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.89
|
| Rate for Payer: UHC Exchange |
$210.63
|
| Rate for Payer: UHC Medicaid |
$71.07
|
| Rate for Payer: UHCCP DNSP |
$135.89
|
| Rate for Payer: UHCCP Medicaid |
$71.07
|
| Rate for Payer: VA VA |
$135.89
|
|
|
PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$8,255.24
|
|
|
Service Code
|
HCPCS Q5111
|
| Hospital Charge Code |
189200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,191.43 |
| Max. Negotiated Rate |
$8,255.24 |
| Rate for Payer: Aetna Commercial |
$7,429.71
|
| Rate for Payer: ASR ASR |
$8,007.58
|
| Rate for Payer: BCBS Trust/PPO |
$6,779.20
|
| Rate for Payer: BCN Commercial |
$6,779.20
|
| Rate for Payer: Cash Price |
$6,604.19
|
| Rate for Payer: Cofinity Commercial |
$7,759.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,604.19
|
| Rate for Payer: Healthscope Commercial |
$8,007.58
|
| Rate for Payer: Healthscope Whirlpool |
$8,255.24
|
| Rate for Payer: Mclaren Commercial |
$7,429.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,016.95
|
| Rate for Payer: Nomi Health Commercial |
$6,769.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,191.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,264.61
|
|
|
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$4,524.00
|
|
|
Service Code
|
HCPCS Q5108
|
| Hospital Charge Code |
187520
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$4,524.00 |
| Rate for Payer: Aetna Commercial |
$4,071.60
|
| Rate for Payer: Aetna Commercial |
$5,054.40
|
| Rate for Payer: Aetna Medicare |
$79.50
|
| Rate for Payer: Aetna Medicare |
$79.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.38
|
| Rate for Payer: ASR ASR |
$4,388.28
|
| Rate for Payer: ASR ASR |
$5,447.52
|
| Rate for Payer: BCBS Complete |
$43.66
|
| Rate for Payer: BCBS Complete |
$43.66
|
| Rate for Payer: BCBS MAPPO |
$79.50
|
| Rate for Payer: BCBS MAPPO |
$79.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,630.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,730.04
|
| Rate for Payer: BCN Commercial |
$4,630.39
|
| Rate for Payer: BCN Commercial |
$3,730.04
|
| Rate for Payer: BCN Medicare Advantage |
$79.50
|
| Rate for Payer: BCN Medicare Advantage |
$79.50
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$4,492.80
|
| Rate for Payer: Cash Price |
$4,492.80
|
| Rate for Payer: Cofinity Commercial |
$4,252.56
|
| Rate for Payer: Cofinity Commercial |
$5,279.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,619.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.50
|
| Rate for Payer: Healthscope Commercial |
$4,388.28
|
| Rate for Payer: Healthscope Commercial |
$5,447.52
|
| Rate for Payer: Healthscope Whirlpool |
$4,524.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,616.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$79.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$79.50
|
| Rate for Payer: Mclaren Commercial |
$5,054.40
|
| Rate for Payer: Mclaren Commercial |
$4,071.60
|
| Rate for Payer: Mclaren Medicaid |
$79.50
|
| Rate for Payer: Mclaren Medicaid |
$79.50
|
| Rate for Payer: Mclaren Medicare |
$79.50
|
| Rate for Payer: Mclaren Medicare |
$79.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.47
|
| Rate for Payer: Meridian Medicaid |
$43.66
|
| Rate for Payer: Meridian Medicaid |
$43.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,845.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.60
|
| Rate for Payer: Nomi Health Commercial |
$4,605.12
|
| Rate for Payer: Nomi Health Commercial |
$3,709.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,212.00
|
| Rate for Payer: PACE Medicare |
$75.53
|
| Rate for Payer: PACE Medicare |
$75.53
|
| Rate for Payer: PACE SWMI |
$79.50
|
| Rate for Payer: PACE SWMI |
$79.50
|
| Rate for Payer: PHP Commercial |
$87.45
|
| Rate for Payer: PHP Commercial |
$87.45
|
| Rate for Payer: PHP Medicaid |
$42.61
|
| Rate for Payer: PHP Medicaid |
$42.61
|
| Rate for Payer: PHP Medicare Advantage |
$79.50
|
| Rate for Payer: PHP Medicare Advantage |
$79.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.60
|
| Rate for Payer: Priority Health Medicare |
$79.50
|
| Rate for Payer: Priority Health Medicare |
$79.50
|
| Rate for Payer: Priority Health Narrow Network |
$82.08
|
| Rate for Payer: Priority Health Narrow Network |
$82.08
|
| Rate for Payer: Railroad Medicare Medicare |
$79.50
|
| Rate for Payer: Railroad Medicare Medicare |
$79.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,942.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,981.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.50
|
| Rate for Payer: UHC Exchange |
$123.22
|
| Rate for Payer: UHC Exchange |
$123.22
|
| Rate for Payer: UHC Medicaid |
$41.58
|
| Rate for Payer: UHC Medicaid |
$41.58
|
| Rate for Payer: UHCCP DNSP |
$79.50
|
| Rate for Payer: UHCCP DNSP |
$79.50
|
| Rate for Payer: UHCCP Medicaid |
$41.58
|
| Rate for Payer: UHCCP Medicaid |
$41.58
|
| Rate for Payer: VA VA |
$79.50
|
| Rate for Payer: VA VA |
$79.50
|
|
|
PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$4,524.00
|
|
|
Service Code
|
HCPCS Q5108
|
| Hospital Charge Code |
187520
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,393.00 |
| Max. Negotiated Rate |
$4,524.00 |
| Rate for Payer: Aetna Commercial |
$4,071.60
|
| Rate for Payer: Aetna Commercial |
$5,054.40
|
| Rate for Payer: ASR ASR |
$4,388.28
|
| Rate for Payer: ASR ASR |
$5,447.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,715.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,611.86
|
| Rate for Payer: BCN Commercial |
$3,715.11
|
| Rate for Payer: BCN Commercial |
$4,611.86
|
| Rate for Payer: Cash Price |
$4,492.80
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cofinity Commercial |
$5,279.04
|
| Rate for Payer: Cofinity Commercial |
$4,252.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,619.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,492.80
|
| Rate for Payer: Healthscope Commercial |
$4,388.28
|
| Rate for Payer: Healthscope Commercial |
$5,447.52
|
| Rate for Payer: Healthscope Whirlpool |
$5,616.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,524.00
|
| Rate for Payer: Mclaren Commercial |
$5,054.40
|
| Rate for Payer: Mclaren Commercial |
$4,071.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,773.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,845.40
|
| Rate for Payer: Nomi Health Commercial |
$4,605.12
|
| Rate for Payer: Nomi Health Commercial |
$3,709.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,212.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,942.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,981.12
|
|
|
PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC
|
Facility
|
IP
|
$29,263.64
|
|
|
Service Code
|
MSDRG 734
|
| Min. Negotiated Rate |
$16,238.45 |
| Max. Negotiated Rate |
$29,263.64 |
| Rate for Payer: Aetna Medicare |
$17,093.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,366.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,366.39
|
| Rate for Payer: BCBS MAPPO |
$17,093.11
|
| Rate for Payer: BCN Medicare Advantage |
$17,093.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,093.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,093.11
|
| Rate for Payer: Mclaren Medicare |
$17,093.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,947.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,657.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,802.42
|
| Rate for Payer: PACE Medicare |
$16,238.45
|
| Rate for Payer: PACE SWMI |
$17,093.11
|
| Rate for Payer: PHP Commercial |
$18,802.42
|
| Rate for Payer: PHP Medicare Advantage |
$17,093.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29,263.64
|
| Rate for Payer: Priority Health Medicare |
$17,093.11
|
| Rate for Payer: Priority Health Narrow Network |
$23,410.92
|
| Rate for Payer: Railroad Medicare Medicare |
$17,093.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,093.11
|
| Rate for Payer: UHC Exchange |
$26,494.32
|
| Rate for Payer: UHCCP DNSP |
$17,093.11
|
| Rate for Payer: VA VA |
$17,093.11
|
|
|
PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$18,485.56
|
|
|
Service Code
|
MSDRG 735
|
| Min. Negotiated Rate |
$10,871.54 |
| Max. Negotiated Rate |
$18,485.56 |
| Rate for Payer: Aetna Medicare |
$11,443.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,304.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,304.66
|
| Rate for Payer: BCBS MAPPO |
$11,443.73
|
| Rate for Payer: BCN Medicare Advantage |
$11,443.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,443.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,443.73
|
| Rate for Payer: Mclaren Medicare |
$11,443.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,015.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,160.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,588.10
|
| Rate for Payer: PACE Medicare |
$10,871.54
|
| Rate for Payer: PACE SWMI |
$11,443.73
|
| Rate for Payer: PHP Commercial |
$12,588.10
|
| Rate for Payer: PHP Medicare Advantage |
$11,443.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18,485.56
|
| Rate for Payer: Priority Health Medicare |
$11,443.73
|
| Rate for Payer: Priority Health Narrow Network |
$14,788.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11,443.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,443.73
|
| Rate for Payer: UHC Exchange |
$17,737.78
|
| Rate for Payer: UHCCP DNSP |
$11,443.73
|
| Rate for Payer: VA VA |
$11,443.73
|
|
|
PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$1,208.01
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
112201
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$1,208.01 |
| Rate for Payer: Aetna Commercial |
$1,087.21
|
| Rate for Payer: Aetna Medicare |
$31.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.34
|
| Rate for Payer: ASR ASR |
$1,171.77
|
| Rate for Payer: BCBS Complete |
$17.28
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$996.00
|
| Rate for Payer: BCN Commercial |
$996.00
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cofinity Commercial |
$1,135.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$1,171.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,208.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.47
|
| Rate for Payer: Mclaren Commercial |
$1,087.21
|
| Rate for Payer: Mclaren Medicaid |
$31.47
|
| Rate for Payer: Mclaren Medicare |
$31.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.04
|
| Rate for Payer: Meridian Medicaid |
$17.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,026.81
|
| Rate for Payer: Nomi Health Commercial |
$990.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.01
|
| Rate for Payer: PACE Medicare |
$29.90
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Commercial |
$34.62
|
| Rate for Payer: PHP Medicaid |
$16.87
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.17
|
| Rate for Payer: Priority Health Medicare |
$31.47
|
| Rate for Payer: Priority Health Narrow Network |
$26.54
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.47
|
| Rate for Payer: UHC Exchange |
$48.78
|
| Rate for Payer: UHC Medicaid |
$16.46
|
| Rate for Payer: UHCCP DNSP |
$31.47
|
| Rate for Payer: UHCCP Medicaid |
$16.46
|
| Rate for Payer: VA VA |
$31.47
|
|
|
PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$1,208.01
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
112201
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$906.01 |
| Max. Negotiated Rate |
$1,208.01 |
| Rate for Payer: Aetna Commercial |
$1,087.21
|
| Rate for Payer: ASR ASR |
$1,171.77
|
| Rate for Payer: BCBS Trust/PPO |
$992.02
|
| Rate for Payer: BCN Commercial |
$992.02
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cofinity Commercial |
$1,135.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.41
|
| Rate for Payer: Healthscope Commercial |
$1,171.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,208.01
|
| Rate for Payer: Mclaren Commercial |
$1,087.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,026.81
|
| Rate for Payer: Nomi Health Commercial |
$990.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.05
|
|
|
PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE CUSTOM
|
Facility
|
IP
|
$1,208.01
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
301789
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$906.01 |
| Max. Negotiated Rate |
$1,208.01 |
| Rate for Payer: Aetna Commercial |
$1,087.21
|
| Rate for Payer: ASR ASR |
$1,171.77
|
| Rate for Payer: BCBS Trust/PPO |
$992.02
|
| Rate for Payer: BCN Commercial |
$992.02
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cofinity Commercial |
$1,135.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.41
|
| Rate for Payer: Healthscope Commercial |
$1,171.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,208.01
|
| Rate for Payer: Mclaren Commercial |
$1,087.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,026.81
|
| Rate for Payer: Nomi Health Commercial |
$990.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.05
|
|
|
PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE CUSTOM
|
Facility
|
OP
|
$1,208.01
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
301789
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.46 |
| Max. Negotiated Rate |
$1,208.01 |
| Rate for Payer: Aetna Commercial |
$1,087.21
|
| Rate for Payer: Aetna Medicare |
$31.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.34
|
| Rate for Payer: ASR ASR |
$1,171.77
|
| Rate for Payer: BCBS Complete |
$17.28
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$996.00
|
| Rate for Payer: BCN Commercial |
$996.00
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cash Price |
$966.41
|
| Rate for Payer: Cofinity Commercial |
$1,135.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$1,171.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,208.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.47
|
| Rate for Payer: Mclaren Commercial |
$1,087.21
|
| Rate for Payer: Mclaren Medicaid |
$31.47
|
| Rate for Payer: Mclaren Medicare |
$31.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.04
|
| Rate for Payer: Meridian Medicaid |
$17.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,026.81
|
| Rate for Payer: Nomi Health Commercial |
$990.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.01
|
| Rate for Payer: PACE Medicare |
$29.90
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Commercial |
$34.62
|
| Rate for Payer: PHP Medicaid |
$16.87
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.17
|
| Rate for Payer: Priority Health Medicare |
$31.47
|
| Rate for Payer: Priority Health Narrow Network |
$26.54
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.47
|
| Rate for Payer: UHC Exchange |
$48.78
|
| Rate for Payer: UHC Medicaid |
$16.46
|
| Rate for Payer: UHCCP DNSP |
$31.47
|
| Rate for Payer: UHCCP Medicaid |
$16.46
|
| Rate for Payer: VA VA |
$31.47
|
|
|
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION
|
Facility
|
IP
|
$82.77
|
|
|
Service Code
|
HCPCS J2540
|
| Hospital Charge Code |
6085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$62.08 |
| Max. Negotiated Rate |
$82.77 |
| Rate for Payer: Aetna Commercial |
$74.49
|
| Rate for Payer: ASR ASR |
$80.29
|
| Rate for Payer: BCBS Trust/PPO |
$67.97
|
| Rate for Payer: BCN Commercial |
$67.97
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$77.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$80.29
|
| Rate for Payer: Healthscope Whirlpool |
$82.77
|
| Rate for Payer: Mclaren Commercial |
$74.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.84
|
|
|
PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION
|
Facility
|
OP
|
$82.77
|
|
|
Service Code
|
HCPCS J2540
|
| Hospital Charge Code |
6085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$82.77 |
| Rate for Payer: Aetna Commercial |
$74.49
|
| Rate for Payer: Aetna Medicare |
$30.62
|
| Rate for Payer: ASR ASR |
$80.29
|
| Rate for Payer: BCBS Complete |
$33.11
|
| Rate for Payer: BCBS Trust/PPO |
$68.24
|
| Rate for Payer: BCN Commercial |
$68.24
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$77.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$80.29
|
| Rate for Payer: Healthscope Whirlpool |
$82.77
|
| Rate for Payer: Mclaren Commercial |
$74.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.81
|
| Rate for Payer: Priority Health Narrow Network |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.84
|
|
|
PENICILLIN V POTASSIUM 250 MG TABLET
|
Facility
|
OP
|
$211.50
|
|
|
Service Code
|
NDC 65862017501
|
| Hospital Charge Code |
6092
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna Commercial |
$190.35
|
| Rate for Payer: Aetna Medicare |
$78.25
|
| Rate for Payer: ASR ASR |
$205.16
|
| Rate for Payer: BCBS Complete |
$84.60
|
| Rate for Payer: BCBS Trust/PPO |
$174.38
|
| Rate for Payer: BCN Commercial |
$174.38
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$198.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$205.16
|
| Rate for Payer: Healthscope Whirlpool |
$211.50
|
| Rate for Payer: Mclaren Commercial |
$190.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.78
|
| Rate for Payer: Nomi Health Commercial |
$173.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.32
|
| Rate for Payer: Priority Health Narrow Network |
$148.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.12
|
|
|
PENICILLIN V POTASSIUM 250 MG TABLET
|
Facility
|
IP
|
$211.50
|
|
|
Service Code
|
NDC 65862017501
|
| Hospital Charge Code |
6092
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.62 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna Commercial |
$190.35
|
| Rate for Payer: ASR ASR |
$205.16
|
| Rate for Payer: BCBS Trust/PPO |
$173.68
|
| Rate for Payer: BCN Commercial |
$173.68
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$198.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$205.16
|
| Rate for Payer: Healthscope Whirlpool |
$211.50
|
| Rate for Payer: Mclaren Commercial |
$190.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.78
|
| Rate for Payer: Nomi Health Commercial |
$173.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.12
|
|
|
PENICILLIN V POTASSIUM 250 MG TABLET
|
Facility
|
OP
|
$176.25
|
|
|
Service Code
|
NDC 57237004001
|
| Hospital Charge Code |
6092
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.21 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$158.62
|
| Rate for Payer: Aetna Medicare |
$65.21
|
| Rate for Payer: ASR ASR |
$170.96
|
| Rate for Payer: BCBS Complete |
$70.50
|
| Rate for Payer: BCBS Trust/PPO |
$145.32
|
| Rate for Payer: BCN Commercial |
$145.32
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$165.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Healthscope Commercial |
$170.96
|
| Rate for Payer: Healthscope Whirlpool |
$176.25
|
| Rate for Payer: Mclaren Commercial |
$158.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: Nomi Health Commercial |
$144.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.43
|
| Rate for Payer: Priority Health Narrow Network |
$123.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.10
|
|
|
PENICILLIN V POTASSIUM 250 MG TABLET
|
Facility
|
IP
|
$176.25
|
|
|
Service Code
|
NDC 57237004001
|
| Hospital Charge Code |
6092
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.19 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$158.62
|
| Rate for Payer: ASR ASR |
$170.96
|
| Rate for Payer: BCBS Trust/PPO |
$144.74
|
| Rate for Payer: BCN Commercial |
$144.74
|
| Rate for Payer: Cash Price |
$141.00
|
| Rate for Payer: Cofinity Commercial |
$165.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.00
|
| Rate for Payer: Healthscope Commercial |
$170.96
|
| Rate for Payer: Healthscope Whirlpool |
$176.25
|
| Rate for Payer: Mclaren Commercial |
$158.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.81
|
| Rate for Payer: Nomi Health Commercial |
$144.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.10
|
|
|
PENIS PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$31,971.56
|
|
|
Service Code
|
MSDRG 709
|
| Min. Negotiated Rate |
$17,586.85 |
| Max. Negotiated Rate |
$31,971.56 |
| Rate for Payer: Aetna Medicare |
$18,512.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,140.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,140.59
|
| Rate for Payer: BCBS MAPPO |
$18,512.47
|
| Rate for Payer: BCN Medicare Advantage |
$18,512.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,512.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,512.47
|
| Rate for Payer: Mclaren Medicare |
$18,512.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,438.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,289.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,363.72
|
| Rate for Payer: PACE Medicare |
$17,586.85
|
| Rate for Payer: PACE SWMI |
$18,512.47
|
| Rate for Payer: PHP Commercial |
$20,363.72
|
| Rate for Payer: PHP Medicare Advantage |
$18,512.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31,971.56
|
| Rate for Payer: Priority Health Medicare |
$18,512.47
|
| Rate for Payer: Priority Health Narrow Network |
$25,577.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18,512.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,512.47
|
| Rate for Payer: UHC Exchange |
$28,694.33
|
| Rate for Payer: UHCCP DNSP |
$18,512.47
|
| Rate for Payer: VA VA |
$18,512.47
|
|
|
PENIS PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,250.81
|
|
|
Service Code
|
MSDRG 710
|
| Min. Negotiated Rate |
$11,252.61 |
| Max. Negotiated Rate |
$19,250.81 |
| Rate for Payer: Aetna Medicare |
$11,844.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,806.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,806.06
|
| Rate for Payer: BCBS MAPPO |
$11,844.85
|
| Rate for Payer: BCN Medicare Advantage |
$11,844.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,844.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,844.85
|
| Rate for Payer: Mclaren Medicare |
$11,844.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,437.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,621.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,029.33
|
| Rate for Payer: PACE Medicare |
$11,252.61
|
| Rate for Payer: PACE SWMI |
$11,844.85
|
| Rate for Payer: PHP Commercial |
$13,029.33
|
| Rate for Payer: PHP Medicare Advantage |
$11,844.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19,250.81
|
| Rate for Payer: Priority Health Medicare |
$11,844.85
|
| Rate for Payer: Priority Health Narrow Network |
$15,400.65
|
| Rate for Payer: Railroad Medicare Medicare |
$11,844.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,844.85
|
| Rate for Payer: UHC Exchange |
$18,359.52
|
| Rate for Payer: UHCCP DNSP |
$11,844.85
|
| Rate for Payer: VA VA |
$11,844.85
|
|
|
PENIS, TESTES AND SCROTAL PROCEDURES
|
Facility
|
IP
|
$8,675.06
|
|
|
Service Code
|
APR-DRG 4832
|
| Min. Negotiated Rate |
$7,843.29 |
| Max. Negotiated Rate |
$8,675.06 |
| Rate for Payer: BCBS Complete |
$8,675.06
|
| Rate for Payer: Mclaren Medicaid |
$8,261.96
|
| Rate for Payer: Meridian Medicaid |
$8,675.06
|
| Rate for Payer: PHP Medicaid |
$7,843.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,261.96
|
| Rate for Payer: UHC Medicaid |
$8,261.96
|
| Rate for Payer: UHCCP Medicaid |
$8,261.96
|
|
|
PENIS, TESTES AND SCROTAL PROCEDURES
|
Facility
|
IP
|
$6,044.04
|
|
|
Service Code
|
APR-DRG 4831
|
| Min. Negotiated Rate |
$5,464.54 |
| Max. Negotiated Rate |
$6,044.04 |
| Rate for Payer: BCBS Complete |
$6,044.04
|
| Rate for Payer: Mclaren Medicaid |
$5,756.23
|
| Rate for Payer: Meridian Medicaid |
$6,044.04
|
| Rate for Payer: PHP Medicaid |
$5,464.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,756.23
|
| Rate for Payer: UHC Medicaid |
$5,756.23
|
| Rate for Payer: UHCCP Medicaid |
$5,756.23
|
|
|
PENIS, TESTES AND SCROTAL PROCEDURES
|
Facility
|
IP
|
$23,244.30
|
|
|
Service Code
|
APR-DRG 4834
|
| Min. Negotiated Rate |
$21,015.63 |
| Max. Negotiated Rate |
$23,244.30 |
| Rate for Payer: BCBS Complete |
$23,244.30
|
| Rate for Payer: Mclaren Medicaid |
$22,137.43
|
| Rate for Payer: Meridian Medicaid |
$23,244.30
|
| Rate for Payer: PHP Medicaid |
$21,015.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,137.43
|
| Rate for Payer: UHC Medicaid |
$22,137.43
|
| Rate for Payer: UHCCP Medicaid |
$22,137.43
|
|
|
PENIS, TESTES AND SCROTAL PROCEDURES
|
Facility
|
IP
|
$12,569.27
|
|
|
Service Code
|
APR-DRG 4833
|
| Min. Negotiated Rate |
$11,364.13 |
| Max. Negotiated Rate |
$12,569.27 |
| Rate for Payer: BCBS Complete |
$12,569.27
|
| Rate for Payer: Mclaren Medicaid |
$11,970.74
|
| Rate for Payer: Meridian Medicaid |
$12,569.27
|
| Rate for Payer: PHP Medicaid |
$11,364.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,970.74
|
| Rate for Payer: UHC Medicaid |
$11,970.74
|
| Rate for Payer: UHCCP Medicaid |
$11,970.74
|
|
|
PEN NEEDLE, DIABETIC, SAFETY 30 GAUGE X 1/3" (8MM)
|
Facility
|
IP
|
$300.81
|
|
|
Service Code
|
NDC 169185275
|
| Hospital Charge Code |
117156
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$225.61 |
| Max. Negotiated Rate |
$300.81 |
| Rate for Payer: Aetna Commercial |
$270.73
|
| Rate for Payer: ASR ASR |
$291.79
|
| Rate for Payer: BCBS Trust/PPO |
$247.03
|
| Rate for Payer: BCN Commercial |
$247.03
|
| Rate for Payer: Cash Price |
$240.65
|
| Rate for Payer: Cofinity Commercial |
$282.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.65
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Healthscope Whirlpool |
$300.81
|
| Rate for Payer: Mclaren Commercial |
$270.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.69
|
| Rate for Payer: Nomi Health Commercial |
$246.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.71
|
|
|
PEN NEEDLE, DIABETIC, SAFETY 30 GAUGE X 1/3" (8MM)
|
Facility
|
OP
|
$300.81
|
|
|
Service Code
|
NDC 169185275
|
| Hospital Charge Code |
117156
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$300.81 |
| Rate for Payer: Aetna Commercial |
$270.73
|
| Rate for Payer: Aetna Medicare |
$111.30
|
| Rate for Payer: ASR ASR |
$291.79
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS Trust/PPO |
$248.02
|
| Rate for Payer: BCN Commercial |
$248.02
|
| Rate for Payer: Cash Price |
$240.65
|
| Rate for Payer: Cofinity Commercial |
$282.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.65
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Healthscope Whirlpool |
$300.81
|
| Rate for Payer: Mclaren Commercial |
$270.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.69
|
| Rate for Payer: Nomi Health Commercial |
$246.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$263.57
|
| Rate for Payer: Priority Health Narrow Network |
$210.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.71
|
|
|
PEPTAMEN AF BOLUS FEED
|
Facility
|
OP
|
$14.80
|
|
|
Service Code
|
NDC 98716066370
|
| Hospital Charge Code |
150863
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.48 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Aetna Commercial |
$13.32
|
| Rate for Payer: Aetna Medicare |
$5.48
|
| Rate for Payer: ASR ASR |
$14.36
|
| Rate for Payer: BCBS Complete |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$12.20
|
| Rate for Payer: BCN Commercial |
$12.20
|
| Rate for Payer: Cash Price |
$11.84
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.84
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Healthscope Whirlpool |
$14.80
|
| Rate for Payer: Mclaren Commercial |
$13.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.58
|
| Rate for Payer: Nomi Health Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.97
|
| Rate for Payer: Priority Health Narrow Network |
$10.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.02
|
|
