|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$102.90
|
|
|
Service Code
|
NDC 66993001968
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$92.61 |
| Rate for Payer: Aetna Commercial |
$87.47
|
| Rate for Payer: Aetna Medicare |
$51.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.89
|
| Rate for Payer: BCBS Complete |
$41.16
|
| Rate for Payer: Cash Price |
$82.32
|
| Rate for Payer: Cofinity Advantage |
$72.03
|
| Rate for Payer: Cofinity Commercial |
$88.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.32
|
| Rate for Payer: Healthscope Commercial |
$92.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.17
|
| Rate for Payer: PHP Commercial |
$87.47
|
| Rate for Payer: Priority Health SBD |
$64.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.89
|
| Rate for Payer: UHC Core |
$53.61
|
| Rate for Payer: UHC Exchange |
$40.44
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.76
|
| Rate for Payer: UHC Core |
$26.26
|
| Rate for Payer: UHC Exchange |
$19.81
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$9,550.60
|
|
|
Service Code
|
APR-DRG 0223
|
| Min. Negotiated Rate |
$9,095.81 |
| Max. Negotiated Rate |
$9,550.60 |
| Rate for Payer: BCBS Complete |
$9,550.60
|
| Rate for Payer: Mclaren Medicaid |
$9,095.81
|
| Rate for Payer: Meridian Medicaid |
$9,550.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,095.81
|
| Rate for Payer: UHC Medicaid |
$9,095.81
|
| Rate for Payer: UHCCP Medicaid |
$9,095.81
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$8,840.29
|
|
|
Service Code
|
APR-DRG 0221
|
| Min. Negotiated Rate |
$8,419.32 |
| Max. Negotiated Rate |
$8,840.29 |
| Rate for Payer: BCBS Complete |
$8,840.29
|
| Rate for Payer: Mclaren Medicaid |
$8,419.32
|
| Rate for Payer: Meridian Medicaid |
$8,840.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,419.32
|
| Rate for Payer: UHC Medicaid |
$8,419.32
|
| Rate for Payer: UHCCP Medicaid |
$8,419.32
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$24,014.39
|
|
|
Service Code
|
APR-DRG 0224
|
| Min. Negotiated Rate |
$22,870.85 |
| Max. Negotiated Rate |
$24,014.39 |
| Rate for Payer: BCBS Complete |
$24,014.39
|
| Rate for Payer: Mclaren Medicaid |
$22,870.85
|
| Rate for Payer: Meridian Medicaid |
$24,014.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,870.85
|
| Rate for Payer: UHC Medicaid |
$22,870.85
|
| Rate for Payer: UHCCP Medicaid |
$22,870.85
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$8,926.85
|
|
|
Service Code
|
APR-DRG 0222
|
| Min. Negotiated Rate |
$8,501.77 |
| Max. Negotiated Rate |
$8,926.85 |
| Rate for Payer: BCBS Complete |
$8,926.85
|
| Rate for Payer: Mclaren Medicaid |
$8,501.77
|
| Rate for Payer: Meridian Medicaid |
$8,926.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,501.77
|
| Rate for Payer: UHC Medicaid |
$8,501.77
|
| Rate for Payer: UHCCP Medicaid |
$8,501.77
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$39,788.92
|
|
|
Service Code
|
MSDRG 032
|
| Min. Negotiated Rate |
$16,195.46 |
| Max. Negotiated Rate |
$39,788.92 |
| Rate for Payer: PHP Medicare Advantage |
$17,047.85
|
| Rate for Payer: Aetna Medicare |
$17,729.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,309.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,309.81
|
| Rate for Payer: BCBS MAPPO |
$17,047.85
|
| Rate for Payer: BCBS Trust/PPO |
$39,788.92
|
| Rate for Payer: BCN Commercial |
$39,788.92
|
| Rate for Payer: BCN Medicare Advantage |
$17,047.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,047.85
|
| Rate for Payer: Mclaren Medicare |
$17,047.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,900.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,605.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,752.63
|
| Rate for Payer: Nomi Health Commercial |
$27,489.90
|
| Rate for Payer: PACE Medicare |
$16,195.46
|
| Rate for Payer: PACE SWMI |
$17,047.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,356.28
|
| Rate for Payer: Priority Health Medicare |
$17,047.85
|
| Rate for Payer: Priority Health Tiered Network |
$27,485.02
|
| Rate for Payer: Railroad Medicare Medicare |
$17,047.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,735.30
|
| Rate for Payer: UHC Core |
$29,060.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,047.85
|
| Rate for Payer: UHC Exchange |
$23,732.95
|
| Rate for Payer: VA VA |
$17,047.85
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$92,742.50
|
|
|
Service Code
|
MSDRG 031
|
| Min. Negotiated Rate |
$33,445.05 |
| Max. Negotiated Rate |
$92,742.50 |
| Rate for Payer: Aetna Medicare |
$36,613.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,006.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,006.65
|
| Rate for Payer: BCBS MAPPO |
$35,205.32
|
| Rate for Payer: BCBS Trust/PPO |
$92,742.50
|
| Rate for Payer: BCN Commercial |
$92,742.50
|
| Rate for Payer: BCN Medicare Advantage |
$35,205.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,205.32
|
| Rate for Payer: Mclaren Medicare |
$35,205.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,965.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,486.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$38,725.85
|
| Rate for Payer: Nomi Health Commercial |
$57,798.45
|
| Rate for Payer: PACE Medicare |
$33,445.05
|
| Rate for Payer: PACE SWMI |
$35,205.32
|
| Rate for Payer: PHP Medicare Advantage |
$35,205.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72,235.25
|
| Rate for Payer: Priority Health Medicare |
$35,205.32
|
| Rate for Payer: Priority Health Tiered Network |
$57,788.19
|
| Rate for Payer: Railroad Medicare Medicare |
$35,205.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73,032.15
|
| Rate for Payer: UHC Core |
$61,100.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35,205.32
|
| Rate for Payer: UHC Exchange |
$49,899.33
|
| Rate for Payer: VA VA |
$35,205.32
|
|
|
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$36,380.71
|
|
|
Service Code
|
MSDRG 033
|
| Min. Negotiated Rate |
$12,758.75 |
| Max. Negotiated Rate |
$36,380.71 |
| Rate for Payer: Aetna Medicare |
$13,967.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,787.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,787.83
|
| Rate for Payer: BCBS MAPPO |
$13,430.26
|
| Rate for Payer: BCBS Trust/PPO |
$36,380.71
|
| Rate for Payer: BCN Commercial |
$36,380.71
|
| Rate for Payer: BCN Medicare Advantage |
$13,430.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,430.26
|
| Rate for Payer: Mclaren Medicare |
$13,430.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,101.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,444.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,773.29
|
| Rate for Payer: Nomi Health Commercial |
$21,451.41
|
| Rate for Payer: PACE Medicare |
$12,758.75
|
| Rate for Payer: PACE SWMI |
$13,430.26
|
| Rate for Payer: PHP Medicare Advantage |
$13,430.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,809.51
|
| Rate for Payer: Priority Health Medicare |
$13,430.26
|
| Rate for Payer: Priority Health Tiered Network |
$21,447.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13,430.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,105.27
|
| Rate for Payer: UHC Core |
$22,676.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,430.26
|
| Rate for Payer: UHC Exchange |
$18,519.72
|
| Rate for Payer: VA VA |
$13,430.26
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.79
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$16.01 |
| Rate for Payer: Aetna Commercial |
$15.12
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.56
|
| Rate for Payer: BCBS Complete |
$7.12
|
| Rate for Payer: Cash Price |
$14.23
|
| Rate for Payer: Cofinity Advantage |
$12.45
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.23
|
| Rate for Payer: Healthscope Commercial |
$16.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.34
|
| Rate for Payer: PHP Commercial |
$15.12
|
| Rate for Payer: Priority Health SBD |
$11.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.56
|
| Rate for Payer: UHC Core |
$9.27
|
| Rate for Payer: UHC Exchange |
$6.99
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
NDC 00409114405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$13.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.44
|
| Rate for Payer: UHC Core |
$13.98
|
| Rate for Payer: UHC Exchange |
$10.54
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.41
|
|
|
Service Code
|
NDC 55150034225
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: Cash Price |
$12.33
|
| Rate for Payer: Cofinity Advantage |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$13.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.33
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.56
|
| Rate for Payer: PHP Commercial |
$13.10
|
| Rate for Payer: Priority Health SBD |
$9.71
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.23
|
|
|
Service Code
|
NDC 00409114402
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.10
|
| Rate for Payer: BCBS Complete |
$9.29
|
| Rate for Payer: Cash Price |
$18.58
|
| Rate for Payer: Cofinity Advantage |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$20.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.42
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health SBD |
$14.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.10
|
| Rate for Payer: UHC Core |
$12.10
|
| Rate for Payer: UHC Exchange |
$9.13
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
NDC 55150034201
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$13.10
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: Cash Price |
$12.33
|
| Rate for Payer: Cofinity Advantage |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$13.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.33
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.56
|
| Rate for Payer: PHP Commercial |
$13.10
|
| Rate for Payer: Priority Health SBD |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.02
|
| Rate for Payer: UHC Core |
$8.03
|
| Rate for Payer: UHC Exchange |
$6.06
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
NDC 55150034225
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$13.10
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: Cash Price |
$12.33
|
| Rate for Payer: Cofinity Advantage |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$13.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.33
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.56
|
| Rate for Payer: PHP Commercial |
$13.10
|
| Rate for Payer: Priority Health SBD |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.02
|
| Rate for Payer: UHC Core |
$8.03
|
| Rate for Payer: UHC Exchange |
$6.06
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.41
|
|
|
Service Code
|
NDC 55150034201
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: Cash Price |
$12.33
|
| Rate for Payer: Cofinity Advantage |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$13.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.33
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.56
|
| Rate for Payer: PHP Commercial |
$13.10
|
| Rate for Payer: Priority Health SBD |
$9.71
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
NDC 00409114405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health SBD |
$16.90
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.62
|
|
|
Service Code
|
NDC 70756060582
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.32 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Medicare |
$9.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.10
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Advantage |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: Priority Health SBD |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC Core |
$9.70
|
| Rate for Payer: UHC Exchange |
$7.32
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.23
|
|
|
Service Code
|
NDC 00409114402
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.63 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.10
|
| Rate for Payer: Cash Price |
$18.58
|
| Rate for Payer: Cofinity Advantage |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$20.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.42
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health SBD |
$14.63
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$213.19 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Advantage |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health SBD |
$213.19
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.07 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna Medicare |
$168.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.43
|
| Rate for Payer: BCBS Complete |
$134.42
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Advantage |
$235.24
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health SBD |
$211.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.43
|
| Rate for Payer: UHC Core |
$175.08
|
| Rate for Payer: UHC Exchange |
$132.07
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$338.40
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.99 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna Medicare |
$169.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: BCBS Complete |
$135.36
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Advantage |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.96
|
| Rate for Payer: UHC Core |
$176.31
|
| Rate for Payer: UHC Exchange |
$132.99
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$336.05
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$211.71 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.43
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Advantage |
$235.24
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health SBD |
$211.71
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$330.52 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Advantage |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.48
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health SBD |
$330.52
|
|
