Provider Network of America: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Provider Network of America appears in disclosed negotiated rates across 1 hospital and 195 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.

195 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
7-0 PROLENE BLUE 1X30IN BV-1 DOUBLE ARMED EVP Inpatient	University of Michigan Health	SUP-93040 CDM	$344	$138	$148 – $366	—
7-0 PROLENE BLUE 1X30IN BV-1 DOUBLE ARMED EVP Outpatient	University of Michigan Health	SUP-93040 CDM	$344	$138	$148 – $366	—
7-0 PROLENE BLUE 2X24IN BV175-6 DOUBLE ARMED EVP Inpatient	University of Michigan Health	SUP-93033 CDM	$202	$80.87	$86.93 – $215	—
7-0 PROLENE BLUE 2X24IN BV175-6 DOUBLE ARMED EVP Outpatient	University of Michigan Health	SUP-93033 CDM	$202	$80.87	$86.93 – $215	—
ABACAVIR 20 MG/ML ORAL SOLUTION Inpatient	University of Michigan Health	025050000 HCPCS	$450	$180	$194 – $478	—
ABACAVIR 20 MG/ML ORAL SOLUTION Outpatient	University of Michigan Health	025050000 HCPCS	$450	$180	$194 – $478	—
ABACAVIR 300 MG TABLET Inpatient	University of Michigan Health	025050000 HCPCS	$35.63	$14.25	$15.32 – $37.87	—
ABACAVIR 300 MG TABLET Outpatient	University of Michigan Health	025050000 HCPCS	$35.63	$14.25	$15.32 – $37.87	—
ABACAVIR 600 MG-DOLUTEGRAVIR 50 MG-LAMIVUDINE 300 MG TABLET Inpatient	University of Michigan Health	025050000 HCPCS	$589	$236	$253 – $626	—
ABACAVIR 600 MG-DOLUTEGRAVIR 50 MG-LAMIVUDINE 300 MG TABLET Outpatient	University of Michigan Health	025050000 HCPCS	$589	$236	$253 – $626	—
ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET Inpatient	University of Michigan Health	025050000 HCPCS	$16.79	$6.72	$7.22 – $17.85	—
ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET Outpatient	University of Michigan Health	025050000 HCPCS	$16.79	$6.72	$7.22 – $17.85	—
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION Inpatient	University of Michigan Health	J0129 HCPCS	$5,833	$2,333	$2,508 – $6,200	—
ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION Outpatient	University of Michigan Health	J0129 HCPCS	$5,833	$2,333	$1,093 – $4,958	—
ABIRATERONE 250 MG TABLET Inpatient	University of Michigan Health	025050000 HCPCS	$3.39	$1.36	$1.46 – $3.60	—
ABIRATERONE 250 MG TABLET Outpatient	University of Michigan Health	025050000 HCPCS	$3.39	$1.36	$1.46 – $3.60	—
ABRASOR, DIAMOND COARSE BALL TIP 265 X 4.5MM Inpatient	University of Michigan Health	SUP-88838 CDM	$2,125	$850	$914 – $2,259	—
ABRASOR, DIAMOND COARSE BALL TIP 265 X 4.5MM Outpatient	University of Michigan Health	SUP-88838 CDM	$2,125	$850	$914 – $2,259	—
ABUTMENT, BELLATEK ENCODE HEALING 3.5 X 5.0 X 3MM Inpatient	University of Michigan Health	SUP-T82396 CDM	$191	$76.58	$82.32 – $203	—
ABUTMENT, BELLATEK ENCODE HEALING 3.5 X 5.0 X 3MM Outpatient	University of Michigan Health	SUP-T82396 CDM	$191	$76.58	$82.32 – $203	—
ABUTMENT, BELLATEK ENCODE HEALING 3.5 X 5.0 X 5MM Inpatient	University of Michigan Health	SUP-T82395 CDM	$191	$76.58	$82.32 – $203	—
ABUTMENT, BELLATEK ENCODE HEALING 3.5 X 5.0 X 5MM Outpatient	University of Michigan Health	SUP-T82395 CDM	$191	$76.58	$82.32 – $203	—
ABUTMENT, COCHLEAR BA210 TI 5.5MM W/ HEXGONAL CONNECTION Inpatient	University of Michigan Health	L8690 HCPCS	$3,780	$1,512	$1,626 – $4,018	—
ABUTMENT, COCHLEAR BA210 TI 5.5MM W/ HEXGONAL CONNECTION Outpatient	University of Michigan Health	L8690 HCPCS	$3,780	$1,512	$1,626 – $4,018	—
ABUTMENT, COCHLEAR BA210 TI 8.5MM W/ HEXGONAL CONNECTION Inpatient	University of Michigan Health	L8690 HCPCS	$4,919	$1,968	$2,115 – $5,229	—