|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$42,716.68
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$22,937.33 |
| Max. Negotiated Rate |
$42,716.68 |
| Rate for Payer: Aetna Medicare |
$24,144.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,180.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,180.70
|
| Rate for Payer: BCBS MAPPO |
$24,144.56
|
| Rate for Payer: BCN Medicare Advantage |
$24,144.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,144.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,144.56
|
| Rate for Payer: Mclaren Medicare |
$24,144.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,351.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,766.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$26,559.02
|
| Rate for Payer: PACE Medicare |
$22,937.33
|
| Rate for Payer: PACE SWMI |
$24,144.56
|
| Rate for Payer: PHP Commercial |
$26,559.02
|
| Rate for Payer: PHP Medicare Advantage |
$24,144.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42,716.68
|
| Rate for Payer: Priority Health Medicare |
$24,144.56
|
| Rate for Payer: Priority Health Narrow Network |
$34,173.34
|
| Rate for Payer: Railroad Medicare Medicare |
$24,144.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24,144.56
|
| Rate for Payer: UHC Exchange |
$37,424.07
|
| Rate for Payer: UHCCP DNSP |
$24,144.56
|
| Rate for Payer: VA VA |
$24,144.56
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$62,466.20
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$32,771.53 |
| Max. Negotiated Rate |
$62,466.20 |
| Rate for Payer: Aetna Medicare |
$34,496.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,120.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,120.44
|
| Rate for Payer: BCBS MAPPO |
$34,496.35
|
| Rate for Payer: BCN Medicare Advantage |
$34,496.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,496.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$34,496.35
|
| Rate for Payer: Mclaren Medicare |
$34,496.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,221.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39,670.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$37,945.99
|
| Rate for Payer: PACE Medicare |
$32,771.53
|
| Rate for Payer: PACE SWMI |
$34,496.35
|
| Rate for Payer: PHP Commercial |
$37,945.99
|
| Rate for Payer: PHP Medicare Advantage |
$34,496.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62,466.20
|
| Rate for Payer: Priority Health Medicare |
$34,496.35
|
| Rate for Payer: Priority Health Narrow Network |
$49,972.96
|
| Rate for Payer: Railroad Medicare Medicare |
$34,496.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34,496.35
|
| Rate for Payer: UHC Exchange |
$53,469.34
|
| Rate for Payer: UHCCP DNSP |
$34,496.35
|
| Rate for Payer: VA VA |
$34,496.35
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,661.62
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$18,926.36 |
| Max. Negotiated Rate |
$34,661.62 |
| Rate for Payer: Aetna Medicare |
$19,922.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,903.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,903.10
|
| Rate for Payer: BCBS MAPPO |
$19,922.48
|
| Rate for Payer: BCN Medicare Advantage |
$19,922.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,922.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,922.48
|
| Rate for Payer: Mclaren Medicare |
$19,922.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,918.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,910.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,914.73
|
| Rate for Payer: PACE Medicare |
$18,926.36
|
| Rate for Payer: PACE SWMI |
$19,922.48
|
| Rate for Payer: PHP Commercial |
$21,914.73
|
| Rate for Payer: PHP Medicare Advantage |
$19,922.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34,661.62
|
| Rate for Payer: Priority Health Medicare |
$19,922.48
|
| Rate for Payer: Priority Health Narrow Network |
$27,729.29
|
| Rate for Payer: Railroad Medicare Medicare |
$19,922.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,922.48
|
| Rate for Payer: UHC Exchange |
$30,879.84
|
| Rate for Payer: UHCCP DNSP |
$19,922.48
|
| Rate for Payer: VA VA |
$19,922.48
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$18,801.32
|
|
|
Service Code
|
APR-DRG 9102
|
| Min. Negotiated Rate |
$16,998.64 |
| Max. Negotiated Rate |
$18,801.32 |
| Rate for Payer: BCBS Complete |
$18,801.32
|
| Rate for Payer: Mclaren Medicaid |
$17,906.02
|
| Rate for Payer: Meridian Medicaid |
$18,801.32
|
| Rate for Payer: PHP Medicaid |
$16,998.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,906.02
|
| Rate for Payer: UHC Medicaid |
$17,906.02
|
| Rate for Payer: UHCCP Medicaid |
$17,906.02
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$14,956.15
|
|
|
Service Code
|
APR-DRG 9101
|
| Min. Negotiated Rate |
$13,522.15 |
| Max. Negotiated Rate |
$14,956.15 |
| Rate for Payer: BCBS Complete |
$14,956.15
|
| Rate for Payer: Mclaren Medicaid |
$14,243.95
|
| Rate for Payer: Meridian Medicaid |
$14,956.15
|
| Rate for Payer: PHP Medicaid |
$13,522.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,243.95
|
| Rate for Payer: UHC Medicaid |
$14,243.95
|
| Rate for Payer: UHCCP Medicaid |
$14,243.95
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$27,419.70
|
|
|
Service Code
|
APR-DRG 9103
|
| Min. Negotiated Rate |
$24,790.69 |
| Max. Negotiated Rate |
$27,419.70 |
| Rate for Payer: BCBS Complete |
$27,419.70
|
| Rate for Payer: Mclaren Medicaid |
$26,114.00
|
| Rate for Payer: Meridian Medicaid |
$27,419.70
|
| Rate for Payer: PHP Medicaid |
$24,790.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,114.00
|
| Rate for Payer: UHC Medicaid |
$26,114.00
|
| Rate for Payer: UHCCP Medicaid |
$26,114.00
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$92,477.24
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$47,715.40 |
| Max. Negotiated Rate |
$92,477.24 |
| Rate for Payer: Aetna Medicare |
$50,226.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,783.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,783.43
|
| Rate for Payer: BCBS MAPPO |
$50,226.74
|
| Rate for Payer: BCN Medicare Advantage |
$50,226.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,226.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$50,226.74
|
| Rate for Payer: Mclaren Medicare |
$50,226.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,738.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,760.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$55,249.41
|
| Rate for Payer: PACE Medicare |
$47,715.40
|
| Rate for Payer: PACE SWMI |
$50,226.74
|
| Rate for Payer: PHP Commercial |
$55,249.41
|
| Rate for Payer: PHP Medicare Advantage |
$50,226.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92,477.24
|
| Rate for Payer: Priority Health Medicare |
$50,226.74
|
| Rate for Payer: Priority Health Narrow Network |
$73,981.79
|
| Rate for Payer: Railroad Medicare Medicare |
$50,226.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50,226.74
|
| Rate for Payer: UHC Exchange |
$77,851.45
|
| Rate for Payer: UHCCP DNSP |
$50,226.74
|
| Rate for Payer: VA VA |
$50,226.74
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$32,306.27
|
|
|
Service Code
|
APR-DRG 9104
|
| Min. Negotiated Rate |
$29,208.73 |
| Max. Negotiated Rate |
$32,306.27 |
| Rate for Payer: BCBS Complete |
$32,306.27
|
| Rate for Payer: Mclaren Medicaid |
$30,767.88
|
| Rate for Payer: Meridian Medicaid |
$32,306.27
|
| Rate for Payer: PHP Medicaid |
$29,208.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,767.88
|
| Rate for Payer: UHC Medicaid |
$30,767.88
|
| Rate for Payer: UHCCP Medicaid |
$30,767.88
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$78,727.45
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$40,868.75 |
| Max. Negotiated Rate |
$78,727.45 |
| Rate for Payer: Aetna Medicare |
$43,019.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53,774.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53,774.68
|
| Rate for Payer: BCBS MAPPO |
$43,019.74
|
| Rate for Payer: BCN Medicare Advantage |
$43,019.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,019.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$43,019.74
|
| Rate for Payer: Mclaren Medicare |
$43,019.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45,170.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,472.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$47,321.71
|
| Rate for Payer: PACE Medicare |
$40,868.75
|
| Rate for Payer: PACE SWMI |
$43,019.74
|
| Rate for Payer: PHP Commercial |
$47,321.71
|
| Rate for Payer: PHP Medicare Advantage |
$43,019.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78,727.45
|
| Rate for Payer: Priority Health Medicare |
$43,019.74
|
| Rate for Payer: Priority Health Narrow Network |
$62,981.96
|
| Rate for Payer: Railroad Medicare Medicare |
$43,019.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43,019.74
|
| Rate for Payer: UHC Exchange |
$66,680.60
|
| Rate for Payer: UHCCP DNSP |
$43,019.74
|
| Rate for Payer: VA VA |
$43,019.74
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$53,744.81
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$28,428.75 |
| Max. Negotiated Rate |
$53,744.81 |
| Rate for Payer: Aetna Medicare |
$29,925.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,406.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,406.25
|
| Rate for Payer: BCBS MAPPO |
$29,925.00
|
| Rate for Payer: BCN Medicare Advantage |
$29,925.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,925.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$29,925.00
|
| Rate for Payer: Mclaren Medicare |
$29,925.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,421.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,413.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$32,917.50
|
| Rate for Payer: PACE Medicare |
$28,428.75
|
| Rate for Payer: PACE SWMI |
$29,925.00
|
| Rate for Payer: PHP Commercial |
$32,917.50
|
| Rate for Payer: PHP Medicare Advantage |
$29,925.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53,744.81
|
| Rate for Payer: Priority Health Medicare |
$29,925.00
|
| Rate for Payer: Priority Health Narrow Network |
$42,995.85
|
| Rate for Payer: Railroad Medicare Medicare |
$29,925.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29,925.00
|
| Rate for Payer: UHC Exchange |
$46,383.75
|
| Rate for Payer: UHCCP DNSP |
$29,925.00
|
| Rate for Payer: VA VA |
$29,925.00
|
|
|
CROMOLYN 4 % EYE DROPS
|
Facility
|
IP
|
$24.35
|
|
|
Service Code
|
NDC 61314023710
|
| Hospital Charge Code |
9691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: ASR ASR |
$23.61
|
| Rate for Payer: BCBS Trust/PPO |
$19.99
|
| Rate for Payer: BCN Commercial |
$19.99
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Healthscope Commercial |
$23.61
|
| Rate for Payer: Healthscope Whirlpool |
$24.34
|
| Rate for Payer: Mclaren Commercial |
$21.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.69
|
| Rate for Payer: Nomi Health Commercial |
$19.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.42
|
|
|
CROMOLYN 4 % EYE DROPS
|
Facility
|
OP
|
$24.35
|
|
|
Service Code
|
NDC 61314023710
|
| Hospital Charge Code |
9691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: Aetna Medicare |
$9.01
|
| Rate for Payer: ASR ASR |
$23.61
|
| Rate for Payer: BCBS Complete |
$9.74
|
| Rate for Payer: BCBS Trust/PPO |
$20.07
|
| Rate for Payer: BCN Commercial |
$20.07
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Healthscope Commercial |
$23.61
|
| Rate for Payer: Healthscope Whirlpool |
$24.34
|
| Rate for Payer: Mclaren Commercial |
$21.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.69
|
| Rate for Payer: Nomi Health Commercial |
$19.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.33
|
| Rate for Payer: Priority Health Narrow Network |
$17.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.42
|
|
|
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$213.86
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
108145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.13 |
| Max. Negotiated Rate |
$213.86 |
| Rate for Payer: Aetna Commercial |
$192.47
|
| Rate for Payer: Aetna Medicare |
$79.13
|
| Rate for Payer: ASR ASR |
$207.44
|
| Rate for Payer: BCBS Complete |
$85.54
|
| Rate for Payer: BCBS Trust/PPO |
$176.33
|
| Rate for Payer: BCN Commercial |
$176.33
|
| Rate for Payer: Cash Price |
$171.09
|
| Rate for Payer: Cofinity Commercial |
$201.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.09
|
| Rate for Payer: Healthscope Commercial |
$207.44
|
| Rate for Payer: Healthscope Whirlpool |
$213.86
|
| Rate for Payer: Mclaren Commercial |
$192.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.78
|
| Rate for Payer: Nomi Health Commercial |
$175.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$187.38
|
| Rate for Payer: Priority Health Narrow Network |
$149.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.20
|
|
|
CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$213.86
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
108145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$213.86 |
| Rate for Payer: Aetna Commercial |
$192.47
|
| Rate for Payer: ASR ASR |
$207.44
|
| Rate for Payer: BCBS Trust/PPO |
$175.62
|
| Rate for Payer: BCN Commercial |
$175.62
|
| Rate for Payer: Cash Price |
$171.09
|
| Rate for Payer: Cofinity Commercial |
$201.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.09
|
| Rate for Payer: Healthscope Commercial |
$207.44
|
| Rate for Payer: Healthscope Whirlpool |
$213.86
|
| Rate for Payer: Mclaren Commercial |
$192.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.78
|
| Rate for Payer: Nomi Health Commercial |
$175.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.20
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$9,214.01
|
|
|
Service Code
|
APR-DRG 0453
|
| Min. Negotiated Rate |
$8,330.57 |
| Max. Negotiated Rate |
$9,214.01 |
| Rate for Payer: BCBS Complete |
$9,214.01
|
| Rate for Payer: Mclaren Medicaid |
$8,775.25
|
| Rate for Payer: Meridian Medicaid |
$9,214.01
|
| Rate for Payer: PHP Medicaid |
$8,330.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,775.25
|
| Rate for Payer: UHC Medicaid |
$8,775.25
|
| Rate for Payer: UHCCP Medicaid |
$8,775.25
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$4,625.54
|
|
|
Service Code
|
APR-DRG 0451
|
| Min. Negotiated Rate |
$4,182.04 |
| Max. Negotiated Rate |
$4,625.54 |
| Rate for Payer: BCBS Complete |
$4,625.54
|
| Rate for Payer: Mclaren Medicaid |
$4,405.27
|
| Rate for Payer: Meridian Medicaid |
$4,625.54
|
| Rate for Payer: PHP Medicaid |
$4,182.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,405.27
|
| Rate for Payer: UHC Medicaid |
$4,405.27
|
| Rate for Payer: UHCCP Medicaid |
$4,405.27
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$6,130.14
|
|
|
Service Code
|
APR-DRG 0452
|
| Min. Negotiated Rate |
$5,542.38 |
| Max. Negotiated Rate |
$6,130.14 |
| Rate for Payer: BCBS Complete |
$6,130.14
|
| Rate for Payer: Mclaren Medicaid |
$5,838.23
|
| Rate for Payer: Meridian Medicaid |
$6,130.14
|
| Rate for Payer: PHP Medicaid |
$5,542.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,838.23
|
| Rate for Payer: UHC Medicaid |
$5,838.23
|
| Rate for Payer: UHCCP Medicaid |
$5,838.23
|
|
|
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION
|
Facility
|
IP
|
$13,490.24
|
|
|
Service Code
|
APR-DRG 0454
|
| Min. Negotiated Rate |
$12,196.79 |
| Max. Negotiated Rate |
$13,490.24 |
| Rate for Payer: BCBS Complete |
$13,490.24
|
| Rate for Payer: Mclaren Medicaid |
$12,847.84
|
| Rate for Payer: Meridian Medicaid |
$13,490.24
|
| Rate for Payer: PHP Medicaid |
$12,196.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,847.84
|
| Rate for Payer: UHC Medicaid |
$12,847.84
|
| Rate for Payer: UHCCP Medicaid |
$12,847.84
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$17.43
|
|
|
Service Code
|
HCPCS J3420
|
| Hospital Charge Code |
2007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$17.43 |
| Rate for Payer: Aetna Commercial |
$15.68
|
| Rate for Payer: Aetna Commercial |
$11.77
|
| Rate for Payer: Aetna Commercial |
$11.65
|
| Rate for Payer: Aetna Commercial |
$15.78
|
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Medicare |
$4.84
|
| Rate for Payer: Aetna Medicare |
$4.64
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna Medicare |
$6.49
|
| Rate for Payer: Aetna Medicare |
$9.98
|
| Rate for Payer: Aetna Medicare |
$6.45
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: ASR ASR |
$16.90
|
| Rate for Payer: ASR ASR |
$12.56
|
| Rate for Payer: ASR ASR |
$12.17
|
| Rate for Payer: ASR ASR |
$12.69
|
| Rate for Payer: ASR ASR |
$17.62
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: ASR ASR |
$17.01
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS Complete |
$10.79
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS Complete |
$6.97
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCBS Trust/PPO |
$14.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCBS Trust/PPO |
$10.34
|
| Rate for Payer: BCBS Trust/PPO |
$10.68
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCBS Trust/PPO |
$14.97
|
| Rate for Payer: BCN Commercial |
$14.97
|
| Rate for Payer: BCN Commercial |
$14.45
|
| Rate for Payer: BCN Commercial |
$10.68
|
| Rate for Payer: BCN Commercial |
$10.34
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Commercial |
$22.24
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$14.53
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$14.53
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$16.38
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Cofinity Commercial |
$16.48
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.53
|
| Rate for Payer: Healthscope Commercial |
$17.62
|
| Rate for Payer: Healthscope Commercial |
$12.69
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Healthscope Commercial |
$12.17
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Healthscope Commercial |
$16.90
|
| Rate for Payer: Healthscope Whirlpool |
$18.16
|
| Rate for Payer: Healthscope Whirlpool |
$17.43
|
| Rate for Payer: Healthscope Whirlpool |
$12.95
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Healthscope Whirlpool |
$12.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.53
|
| Rate for Payer: Healthscope Whirlpool |
$13.08
|
| Rate for Payer: Mclaren Commercial |
$11.29
|
| Rate for Payer: Mclaren Commercial |
$11.77
|
| Rate for Payer: Mclaren Commercial |
$11.65
|
| Rate for Payer: Mclaren Commercial |
$15.78
|
| Rate for Payer: Mclaren Commercial |
$15.68
|
| Rate for Payer: Mclaren Commercial |
$16.34
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.44
|
| Rate for Payer: Nomi Health Commercial |
$10.62
|
| Rate for Payer: Nomi Health Commercial |
$10.72
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Nomi Health Commercial |
$14.29
|
| Rate for Payer: Nomi Health Commercial |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$14.89
|
| Rate for Payer: Nomi Health Commercial |
$14.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.66
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: Priority Health Narrow Network |
$0.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.04
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$12.95
|
|
|
Service Code
|
HCPCS J3420
|
| Hospital Charge Code |
2007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$12.95 |
| Rate for Payer: Aetna Commercial |
$11.65
|
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Commercial |
$11.77
|
| Rate for Payer: Aetna Commercial |
$15.78
|
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: Aetna Commercial |
$15.68
|
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: ASR ASR |
$17.01
|
| Rate for Payer: ASR ASR |
$12.69
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: ASR ASR |
$12.17
|
| Rate for Payer: ASR ASR |
$12.56
|
| Rate for Payer: ASR ASR |
$16.90
|
| Rate for Payer: ASR ASR |
$17.62
|
| Rate for Payer: BCBS Trust/PPO |
$22.15
|
| Rate for Payer: BCBS Trust/PPO |
$14.91
|
| Rate for Payer: BCBS Trust/PPO |
$14.40
|
| Rate for Payer: BCBS Trust/PPO |
$10.63
|
| Rate for Payer: BCBS Trust/PPO |
$10.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.31
|
| Rate for Payer: BCBS Trust/PPO |
$10.74
|
| Rate for Payer: BCN Commercial |
$14.91
|
| Rate for Payer: BCN Commercial |
$10.74
|
| Rate for Payer: BCN Commercial |
$10.63
|
| Rate for Payer: BCN Commercial |
$14.31
|
| Rate for Payer: BCN Commercial |
$14.40
|
| Rate for Payer: BCN Commercial |
$10.30
|
| Rate for Payer: BCN Commercial |
$22.15
|
| Rate for Payer: Cash Price |
$10.36
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$14.53
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$16.38
|
| Rate for Payer: Cofinity Commercial |
$16.48
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Healthscope Commercial |
$12.69
|
| Rate for Payer: Healthscope Commercial |
$16.90
|
| Rate for Payer: Healthscope Commercial |
$12.17
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Healthscope Commercial |
$17.62
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$17.53
|
| Rate for Payer: Healthscope Whirlpool |
$12.54
|
| Rate for Payer: Healthscope Whirlpool |
$12.95
|
| Rate for Payer: Healthscope Whirlpool |
$18.16
|
| Rate for Payer: Healthscope Whirlpool |
$13.08
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Healthscope Whirlpool |
$17.43
|
| Rate for Payer: Mclaren Commercial |
$11.29
|
| Rate for Payer: Mclaren Commercial |
$15.68
|
| Rate for Payer: Mclaren Commercial |
$11.65
|
| Rate for Payer: Mclaren Commercial |
$15.78
|
| Rate for Payer: Mclaren Commercial |
$16.34
|
| Rate for Payer: Mclaren Commercial |
$11.77
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.12
|
| Rate for Payer: Nomi Health Commercial |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$14.38
|
| Rate for Payer: Nomi Health Commercial |
$10.72
|
| Rate for Payer: Nomi Health Commercial |
$14.89
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Nomi Health Commercial |
$10.62
|
| Rate for Payer: Nomi Health Commercial |
$14.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.43
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
IP
|
$189.18
|
|
|
Service Code
|
NDC 50268085515
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.88 |
| Max. Negotiated Rate |
$189.18 |
| Rate for Payer: Aetna Commercial |
$170.26
|
| Rate for Payer: ASR ASR |
$183.50
|
| Rate for Payer: BCBS Trust/PPO |
$155.35
|
| Rate for Payer: BCN Commercial |
$155.35
|
| Rate for Payer: Cash Price |
$151.34
|
| Rate for Payer: Cofinity Commercial |
$177.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.34
|
| Rate for Payer: Healthscope Commercial |
$183.50
|
| Rate for Payer: Healthscope Whirlpool |
$189.18
|
| Rate for Payer: Mclaren Commercial |
$170.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.80
|
| Rate for Payer: Nomi Health Commercial |
$155.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$166.47
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
OP
|
$189.18
|
|
|
Service Code
|
NDC 50268085515
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.99 |
| Max. Negotiated Rate |
$189.18 |
| Rate for Payer: Aetna Commercial |
$170.26
|
| Rate for Payer: Aetna Medicare |
$69.99
|
| Rate for Payer: ASR ASR |
$183.50
|
| Rate for Payer: BCBS Complete |
$75.67
|
| Rate for Payer: BCBS Trust/PPO |
$155.97
|
| Rate for Payer: BCN Commercial |
$155.97
|
| Rate for Payer: Cash Price |
$151.34
|
| Rate for Payer: Cofinity Commercial |
$177.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.34
|
| Rate for Payer: Healthscope Commercial |
$183.50
|
| Rate for Payer: Healthscope Whirlpool |
$189.18
|
| Rate for Payer: Mclaren Commercial |
$170.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$151.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.80
|
| Rate for Payer: Nomi Health Commercial |
$155.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$165.76
|
| Rate for Payer: Priority Health Narrow Network |
$132.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$166.47
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
IP
|
$4.04
|
|
|
Service Code
|
NDC 77333093825
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$4.04 |
| Rate for Payer: Aetna Commercial |
$3.64
|
| Rate for Payer: ASR ASR |
$3.92
|
| Rate for Payer: BCBS Trust/PPO |
$3.32
|
| Rate for Payer: BCN Commercial |
$3.32
|
| Rate for Payer: Cash Price |
$3.23
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.23
|
| Rate for Payer: Healthscope Commercial |
$3.92
|
| Rate for Payer: Healthscope Whirlpool |
$4.04
|
| Rate for Payer: Mclaren Commercial |
$3.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.44
|
| Rate for Payer: Nomi Health Commercial |
$3.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.56
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
OP
|
$4.04
|
|
|
Service Code
|
NDC 77333093825
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$4.04 |
| Rate for Payer: Aetna Commercial |
$3.64
|
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: ASR ASR |
$3.92
|
| Rate for Payer: BCBS Complete |
$1.62
|
| Rate for Payer: BCBS Trust/PPO |
$3.33
|
| Rate for Payer: BCN Commercial |
$3.33
|
| Rate for Payer: Cash Price |
$3.23
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.23
|
| Rate for Payer: Healthscope Commercial |
$3.92
|
| Rate for Payer: Healthscope Whirlpool |
$4.04
|
| Rate for Payer: Mclaren Commercial |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.44
|
| Rate for Payer: Nomi Health Commercial |
$3.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.54
|
| Rate for Payer: Priority Health Narrow Network |
$2.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.56
|
|
|
CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET
|
Facility
|
OP
|
$171.55
|
|
|
Service Code
|
NDC 20555000600
|
| Hospital Charge Code |
2009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$171.55 |
| Rate for Payer: Aetna Commercial |
$154.40
|
| Rate for Payer: Aetna Medicare |
$63.47
|
| Rate for Payer: ASR ASR |
$166.40
|
| Rate for Payer: BCBS Complete |
$68.62
|
| Rate for Payer: BCBS Trust/PPO |
$141.44
|
| Rate for Payer: BCN Commercial |
$141.44
|
| Rate for Payer: Cash Price |
$137.24
|
| Rate for Payer: Cofinity Commercial |
$161.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.24
|
| Rate for Payer: Healthscope Commercial |
$166.40
|
| Rate for Payer: Healthscope Whirlpool |
$171.55
|
| Rate for Payer: Mclaren Commercial |
$154.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.82
|
| Rate for Payer: Nomi Health Commercial |
$140.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$150.31
|
| Rate for Payer: Priority Health Narrow Network |
$120.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.96
|
|
