MAGELLAN BEHAVIORAL: disclosed hospital rates

iDirect answer

Based on the published hospital price files, MAGELLAN BEHAVIORAL appears in disclosed negotiated rates across 1 hospital and 257 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

257 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
.9 NACL 1000ML Outpatient	Henry Ford Providence Novi Hospital	74699166 CDM	$23.00	$12.88	$5.98 – $23.00	—
ACETAZOLAMIDE(DIAMOX) 500MG IV Outpatient	Henry Ford Providence Novi Hospital	71997639 CDM	$44.00	$24.64	$11.44 – $44.00	—
ADENOSINE 6MG INJ Outpatient	Henry Ford Providence Novi Hospital	71750145 CDM	$70.00	$39.20	$18.20 – $70.00	—
ALBUMIN 25% 12.5GM 50ML VIAL Outpatient	Henry Ford Providence Novi Hospital	79412706 CDM	$97.00	$54.32	$25.22 – $97.00	—
ALBUTEROL INHALER (VENTOLIN) Outpatient	Henry Ford Providence Novi Hospital	71713325 CDM	$41.00	$22.96	$10.66 – $41.00	—
AMICAR 5GM 20ML VIAL Outpatient	Henry Ford Providence Novi Hospital	79412714 CDM	$15.00	$8.40	$3.90 – $15.00	—
ARTERIAL BLOOD DRAW Outpatient	Henry Ford Providence Novi Hospital	73630345 CDM	$35.00	$19.60	$9.10 – $35.00	—
ARTERIAL PUNCTURE*36600 Outpatient	Henry Ford Providence Novi Hospital	67879635 CDM	$35.00	$19.60	$9.10 – $35.00	—
ASP/INJ RENAL CYST OR PELVIS Outpatient	Henry Ford Providence Novi Hospital	72176571 CDM	$1,424	$797	$370 – $1,424	—
ASP/INJ RENAL CYST/PELV*50390 Outpatient	Henry Ford Providence Novi Hospital	72476575 CDM	$1,424	$797	$370 – $1,424	—
ASPIRATE/INJ THYROID CYST Outpatient	Henry Ford Providence Novi Hospital	72102346 CDM	$904	$506	$235 – $904	—
ASPIRIN-BABY 81 MG TAB Outpatient	Henry Ford Providence Novi Hospital	72350176 CDM	$17.00	$9.52	$4.42 – $17.00	—
ATROPINE 1MG INJ VIAL Outpatient	Henry Ford Providence Novi Hospital	71713028 CDM	$23.00	$12.88	$5.98 – $23.00	—
BI-VENT LEAD REPOSITION*33226 Outpatient	Henry Ford Providence Novi Hospital	72710643 CDM	$3,421	$1,916	$889 – $3,421	—
BRACHY NONSTRAND Y90/SOURCE Outpatient	Henry Ford Providence Novi Hospital	71906481 CDM	$35,053	$19,630	$9,114 – $35,053	—
BRACHY NONSTRAND Y90/SOURCE Outpatient	Henry Ford Providence Novi Hospital	74606484 CDM	$35,053	$19,630	$9,114 – $35,053	—
CALCIUM CHLORIDE 1GM/10ML SYR Outpatient	Henry Ford Providence Novi Hospital	33049610 CDM	$0.05	$0.03	$0.01 – $0.05	—
CALCIUM CHLORIDE 1GM/10ML VIAL Outpatient	Henry Ford Providence Novi Hospital	33049602 CDM	$0.05	$0.03	$0.01 – $0.05	—
CARDIZEM 125MG IVPB Outpatient	Henry Ford Providence Novi Hospital	67816223 CDM	$156	$87.36	$40.56 – $156	—
CARDIZEM 25MG INJ VIAL Outpatient	Henry Ford Providence Novi Hospital	67816215 CDM	$32.00	$17.92	$8.32 – $32.00	—
CAROTID STENT W/O PROTEC*37216 Outpatient	Henry Ford Providence Novi Hospital	72360332 CDM	$5,128	$2,872	$1,333 – $5,128	—
CAROTID STENT W/PROTECT*37215 Outpatient	Henry Ford Providence Novi Hospital	72360324 CDM	$6,689	$3,746	$1,739 – $6,689	—
CAROTID STENT W/PROTECT*37215 Outpatient	Henry Ford Providence Novi Hospital	74660325 CDM	$6,689	$3,746	$1,739 – $6,689	—
CHOLANGIOPANCREAT(MRCP)-MRI Outpatient	Henry Ford Providence Novi Hospital	72639040 CDM	$737	$413	$192 – $737	—
CIRCUMCISION Outpatient	Henry Ford Providence Novi Hospital	67110056 CDM	$147	$82.32	$38.22 – $147	—