Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$69.80

Service Code	NDC 65862052730
Hospital Charge Code	27857
Hospital Revenue Code	637
Min. Negotiated Rate	$43.97
Max. Negotiated Rate	$62.82
Rate for Payer: Aetna Commercial	$59.33
Rate for Payer: Aetna New Business (MI Preferred)	$45.37
Rate for Payer: Cash Price	$55.84
Rate for Payer: Cofinity Commercial	$48.86
Rate for Payer: Cofinity Commercial	$60.03
Rate for Payer: Cofinity Medicare Advantage	$48.86
Rate for Payer: Encore Health Key Benefits Commercial	$55.84
Rate for Payer: Healthscope Commercial	$62.82
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$59.33
Rate for Payer: PHP Commercial	$59.33
Rate for Payer: Priority Health Cigna Priority Health	$45.37
Rate for Payer: Priority Health SBD	$43.97

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$226.58

Service Code	NDC 00093738598
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$90.63
Max. Negotiated Rate	$203.92
Rate for Payer: Aetna Commercial	$192.59
Rate for Payer: Aetna Medicare	$113.29
Rate for Payer: Aetna New Business (MI Preferred)	$147.28
Rate for Payer: BCBS Complete	$90.63
Rate for Payer: Cash Price	$181.26
Rate for Payer: Cofinity Commercial	$158.61
Rate for Payer: Cofinity Commercial	$194.86
Rate for Payer: Cofinity Medicare Advantage	$158.61
Rate for Payer: Encore Health Key Benefits Commercial	$181.26
Rate for Payer: Healthscope Commercial	$203.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$192.59
Rate for Payer: PHP Commercial	$192.59
Rate for Payer: Priority Health Cigna Priority Health	$147.28
Rate for Payer: Priority Health SBD	$142.75

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$71.91

Service Code	NDC 65862052830
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$45.30
Max. Negotiated Rate	$64.72
Rate for Payer: Aetna Commercial	$61.12
Rate for Payer: Aetna New Business (MI Preferred)	$46.74
Rate for Payer: Cash Price	$57.53
Rate for Payer: Cofinity Commercial	$50.34
Rate for Payer: Cofinity Commercial	$61.84
Rate for Payer: Cofinity Medicare Advantage	$50.34
Rate for Payer: Encore Health Key Benefits Commercial	$57.53
Rate for Payer: Healthscope Commercial	$64.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.12
Rate for Payer: PHP Commercial	$61.12
Rate for Payer: Priority Health Cigna Priority Health	$46.74
Rate for Payer: Priority Health SBD	$45.30

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$226.58

Service Code	NDC 00093738598
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$203.92
Rate for Payer: Aetna Commercial	$192.59
Rate for Payer: Aetna New Business (MI Preferred)	$147.28
Rate for Payer: Cash Price	$181.26
Rate for Payer: Cofinity Commercial	$158.61
Rate for Payer: Cofinity Commercial	$194.86
Rate for Payer: Cofinity Medicare Advantage	$158.61
Rate for Payer: Encore Health Key Benefits Commercial	$181.26
Rate for Payer: Healthscope Commercial	$203.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$192.59
Rate for Payer: PHP Commercial	$192.59
Rate for Payer: Priority Health Cigna Priority Health	$147.28
Rate for Payer: Priority Health SBD	$142.75

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$215.73

Service Code	NDC 65862052890
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$86.29
Max. Negotiated Rate	$194.16
Rate for Payer: Aetna Commercial	$183.37
Rate for Payer: Aetna Medicare	$107.86
Rate for Payer: Aetna New Business (MI Preferred)	$140.22
Rate for Payer: BCBS Complete	$86.29
Rate for Payer: Cash Price	$172.58
Rate for Payer: Cofinity Commercial	$151.01
Rate for Payer: Cofinity Commercial	$185.53
Rate for Payer: Cofinity Medicare Advantage	$151.01
Rate for Payer: Encore Health Key Benefits Commercial	$172.58
Rate for Payer: Healthscope Commercial	$194.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$183.37
Rate for Payer: PHP Commercial	$183.37
Rate for Payer: Priority Health Cigna Priority Health	$140.22
Rate for Payer: Priority Health SBD	$135.91

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$296.40

Service Code	NDC 00904646961
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$186.73
Max. Negotiated Rate	$266.76
Rate for Payer: Aetna Commercial	$251.94
Rate for Payer: Aetna New Business (MI Preferred)	$192.66
Rate for Payer: Cash Price	$237.12
Rate for Payer: Cofinity Commercial	$207.48
Rate for Payer: Cofinity Commercial	$254.90
Rate for Payer: Cofinity Medicare Advantage	$207.48
Rate for Payer: Encore Health Key Benefits Commercial	$237.12
Rate for Payer: Healthscope Commercial	$266.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$251.94
Rate for Payer: PHP Commercial	$251.94
Rate for Payer: Priority Health Cigna Priority Health	$192.66
Rate for Payer: Priority Health SBD	$186.73

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$71.91

Service Code	NDC 65862052830
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$28.76
Max. Negotiated Rate	$64.72
Rate for Payer: Aetna Commercial	$61.12
Rate for Payer: Aetna Medicare	$35.96
Rate for Payer: Aetna New Business (MI Preferred)	$46.74
Rate for Payer: BCBS Complete	$28.76
Rate for Payer: Cash Price	$57.53
Rate for Payer: Cofinity Commercial	$50.34
Rate for Payer: Cofinity Commercial	$61.84
Rate for Payer: Cofinity Medicare Advantage	$50.34
Rate for Payer: Encore Health Key Benefits Commercial	$57.53
Rate for Payer: Healthscope Commercial	$64.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$61.12
Rate for Payer: PHP Commercial	$61.12
Rate for Payer: Priority Health Cigna Priority Health	$46.74
Rate for Payer: Priority Health SBD	$45.30

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$4.64

Service Code	NDC 68084070911
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$4.18
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna New Business (MI Preferred)	$3.02
Rate for Payer: Cash Price	$3.71
Rate for Payer: Cofinity Commercial	$3.25
Rate for Payer: Cofinity Commercial	$3.99
Rate for Payer: Cofinity Medicare Advantage	$3.25
Rate for Payer: Encore Health Key Benefits Commercial	$3.71
Rate for Payer: Healthscope Commercial	$4.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.94
Rate for Payer: PHP Commercial	$3.94
Rate for Payer: Priority Health Cigna Priority Health	$3.02
Rate for Payer: Priority Health SBD	$2.92

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$463.60

Service Code	NDC 68084070901
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$185.44
Max. Negotiated Rate	$417.24
Rate for Payer: Aetna Commercial	$394.06
Rate for Payer: Aetna Medicare	$231.80
Rate for Payer: Aetna New Business (MI Preferred)	$301.34
Rate for Payer: BCBS Complete	$185.44
Rate for Payer: Cash Price	$370.88
Rate for Payer: Cofinity Commercial	$324.52
Rate for Payer: Cofinity Commercial	$398.70
Rate for Payer: Cofinity Medicare Advantage	$324.52
Rate for Payer: Encore Health Key Benefits Commercial	$370.88
Rate for Payer: Healthscope Commercial	$417.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$394.06
Rate for Payer: PHP Commercial	$394.06
Rate for Payer: Priority Health Cigna Priority Health	$301.34
Rate for Payer: Priority Health SBD	$292.07

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$215.73

Service Code	NDC 65862052890
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$135.91
Max. Negotiated Rate	$194.16
Rate for Payer: Aetna Commercial	$183.37
Rate for Payer: Aetna New Business (MI Preferred)	$140.22
Rate for Payer: Cash Price	$172.58
Rate for Payer: Cofinity Commercial	$151.01
Rate for Payer: Cofinity Commercial	$185.53
Rate for Payer: Cofinity Medicare Advantage	$151.01
Rate for Payer: Encore Health Key Benefits Commercial	$172.58
Rate for Payer: Healthscope Commercial	$194.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$183.37
Rate for Payer: PHP Commercial	$183.37
Rate for Payer: Priority Health Cigna Priority Health	$140.22
Rate for Payer: Priority Health SBD	$135.91

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$296.40

Service Code	NDC 00904646961
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$118.56
Max. Negotiated Rate	$266.76
Rate for Payer: Aetna Commercial	$251.94
Rate for Payer: Aetna Medicare	$148.20
Rate for Payer: Aetna New Business (MI Preferred)	$192.66
Rate for Payer: BCBS Complete	$118.56
Rate for Payer: Cash Price	$237.12
Rate for Payer: Cofinity Commercial	$207.48
Rate for Payer: Cofinity Commercial	$254.90
Rate for Payer: Cofinity Medicare Advantage	$207.48
Rate for Payer: Encore Health Key Benefits Commercial	$237.12
Rate for Payer: Healthscope Commercial	$266.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$251.94
Rate for Payer: PHP Commercial	$251.94
Rate for Payer: Priority Health Cigna Priority Health	$192.66
Rate for Payer: Priority Health SBD	$186.73

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$4.64

Service Code	NDC 68084070911
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$4.18
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna Medicare	$2.32
Rate for Payer: Aetna New Business (MI Preferred)	$3.02
Rate for Payer: BCBS Complete	$1.86
Rate for Payer: Cash Price	$3.71
Rate for Payer: Cofinity Commercial	$3.25
Rate for Payer: Cofinity Commercial	$3.99
Rate for Payer: Cofinity Medicare Advantage	$3.25
Rate for Payer: Encore Health Key Benefits Commercial	$3.71
Rate for Payer: Healthscope Commercial	$4.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.94
Rate for Payer: PHP Commercial	$3.94
Rate for Payer: Priority Health Cigna Priority Health	$3.02
Rate for Payer: Priority Health SBD	$2.92

VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR

Facility

$463.60

Service Code	NDC 68084070901
Hospital Charge Code	27858
Hospital Revenue Code	637
Min. Negotiated Rate	$292.07
Max. Negotiated Rate	$417.24
Rate for Payer: Aetna Commercial	$394.06
Rate for Payer: Aetna New Business (MI Preferred)	$301.34
Rate for Payer: Cash Price	$370.88
Rate for Payer: Cofinity Commercial	$324.52
Rate for Payer: Cofinity Commercial	$398.70
Rate for Payer: Cofinity Medicare Advantage	$324.52
Rate for Payer: Encore Health Key Benefits Commercial	$370.88
Rate for Payer: Healthscope Commercial	$417.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$394.06
Rate for Payer: PHP Commercial	$394.06
Rate for Payer: Priority Health Cigna Priority Health	$301.34
Rate for Payer: Priority Health SBD	$292.07

VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA

Facility

$9,986.81

Service Code	CPT 69424
Hospital Revenue Code	360
Min. Negotiated Rate	$63.39
Max. Negotiated Rate	$9,986.81
Rate for Payer: Aetna Medicare	$3,304.60
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,971.88
Rate for Payer: Amish Plain Church Group Commercial	$3,971.88
Rate for Payer: BCBS Complete	$1,788.30
Rate for Payer: BCBS MAPPO	$3,177.50
Rate for Payer: BCBS Trust/PPO	$1,831.35
Rate for Payer: BCN Commercial	$1,831.35
Rate for Payer: BCN Medicare Advantage	$3,177.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,177.50
Rate for Payer: Mclaren Medicaid	$1,703.14
Rate for Payer: Mclaren Medicare	$3,177.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$3,336.38
Rate for Payer: Meridian Medicaid	$1,788.30
Rate for Payer: MI Amish Medical Board Commercial	$3,654.12
Rate for Payer: Nomi Health Commercial	$9,532.50
Rate for Payer: PACE Medicare	$3,018.62
Rate for Payer: PACE SWMI	$3,177.50
Rate for Payer: PHP Medicare Advantage	$3,177.50
Rate for Payer: Priority Health Choice Medicaid	$1,703.14
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,986.81
Rate for Payer: Priority Health Medicare	$3,177.50
Rate for Payer: Priority Health Narrow Network	$7,989.45
Rate for Payer: Railroad Medicare Medicare	$3,177.50
Rate for Payer: UHC All Payor (Choice/PPO)	$63.39
Rate for Payer: UHC Core	$5,427.00
Rate for Payer: UHC Dual Complete DSNP	$3,177.50
Rate for Payer: UHC Exchange	$5,811.00
Rate for Payer: UHC Medicare Advantage	$3,177.50
Rate for Payer: UHCCP Medicaid	$1,788.93
Rate for Payer: VA VA	$3,177.50

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$66.78

Service Code	NDC 00173068224
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$26.71
Max. Negotiated Rate	$60.10
Rate for Payer: Aetna Commercial	$56.76
Rate for Payer: Aetna Medicare	$33.39
Rate for Payer: Aetna New Business (MI Preferred)	$43.41
Rate for Payer: BCBS Complete	$26.71
Rate for Payer: Cash Price	$53.42
Rate for Payer: Cofinity Commercial	$46.75
Rate for Payer: Cofinity Commercial	$57.43
Rate for Payer: Cofinity Medicare Advantage	$46.75
Rate for Payer: Encore Health Key Benefits Commercial	$53.42
Rate for Payer: Healthscope Commercial	$60.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$56.76
Rate for Payer: PHP Commercial	$56.76
Rate for Payer: Priority Health Cigna Priority Health	$43.41
Rate for Payer: Priority Health SBD	$42.07

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$102.90

Service Code	NDC 66993001968
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$41.16
Max. Negotiated Rate	$92.61
Rate for Payer: Aetna Commercial	$87.46
Rate for Payer: Aetna Medicare	$51.45
Rate for Payer: Aetna New Business (MI Preferred)	$66.88
Rate for Payer: BCBS Complete	$41.16
Rate for Payer: Cash Price	$82.32
Rate for Payer: Cofinity Commercial	$72.03
Rate for Payer: Cofinity Commercial	$88.49
Rate for Payer: Cofinity Medicare Advantage	$72.03
Rate for Payer: Encore Health Key Benefits Commercial	$82.32
Rate for Payer: Healthscope Commercial	$92.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$87.46
Rate for Payer: PHP Commercial	$87.46
Rate for Payer: Priority Health Cigna Priority Health	$66.88
Rate for Payer: Priority Health SBD	$64.83

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$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 Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
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: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$174.30

Service Code	NDC 00173068220
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$109.81
Max. Negotiated Rate	$156.87
Rate for Payer: Aetna Commercial	$148.16
Rate for Payer: Aetna New Business (MI Preferred)	$113.30
Rate for Payer: Cash Price	$139.44
Rate for Payer: Cofinity Commercial	$122.01
Rate for Payer: Cofinity Commercial	$149.90
Rate for Payer: Cofinity Medicare Advantage	$122.01
Rate for Payer: Encore Health Key Benefits Commercial	$139.44
Rate for Payer: Healthscope Commercial	$156.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$148.16
Rate for Payer: PHP Commercial	$148.16
Rate for Payer: Priority Health Cigna Priority Health	$113.30
Rate for Payer: Priority Health SBD	$109.81

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$102.90

Service Code	NDC 66993001968
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$64.83
Max. Negotiated Rate	$92.61
Rate for Payer: Aetna Commercial	$87.46
Rate for Payer: Aetna New Business (MI Preferred)	$66.88
Rate for Payer: Cash Price	$82.32
Rate for Payer: Cofinity Commercial	$72.03
Rate for Payer: Cofinity Commercial	$88.49
Rate for Payer: Cofinity Medicare Advantage	$72.03
Rate for Payer: Encore Health Key Benefits Commercial	$82.32
Rate for Payer: Healthscope Commercial	$92.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$87.46
Rate for Payer: PHP Commercial	$87.46
Rate for Payer: Priority Health Cigna Priority Health	$66.88
Rate for Payer: Priority Health SBD	$64.83

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$66.78

Service Code	NDC 00173068224
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$42.07
Max. Negotiated Rate	$60.10
Rate for Payer: Aetna Commercial	$56.76
Rate for Payer: Aetna New Business (MI Preferred)	$43.41
Rate for Payer: Cash Price	$53.42
Rate for Payer: Cofinity Commercial	$46.75
Rate for Payer: Cofinity Commercial	$57.43
Rate for Payer: Cofinity Medicare Advantage	$46.75
Rate for Payer: Encore Health Key Benefits Commercial	$53.42
Rate for Payer: Healthscope Commercial	$60.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$56.76
Rate for Payer: PHP Commercial	$56.76
Rate for Payer: Priority Health Cigna Priority Health	$43.41
Rate for Payer: Priority Health SBD	$42.07

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$174.30

Service Code	NDC 00173068220
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$69.72
Max. Negotiated Rate	$156.87
Rate for Payer: Aetna Commercial	$148.16
Rate for Payer: Aetna Medicare	$87.15
Rate for Payer: Aetna New Business (MI Preferred)	$113.30
Rate for Payer: BCBS Complete	$69.72
Rate for Payer: Cash Price	$139.44
Rate for Payer: Cofinity Commercial	$122.01
Rate for Payer: Cofinity Commercial	$149.90
Rate for Payer: Cofinity Medicare Advantage	$122.01
Rate for Payer: Encore Health Key Benefits Commercial	$139.44
Rate for Payer: Healthscope Commercial	$156.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$148.16
Rate for Payer: PHP Commercial	$148.16
Rate for Payer: Priority Health Cigna Priority Health	$113.30
Rate for Payer: Priority Health SBD	$109.81

VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER

Facility

$50.40

Service Code	NDC 69097014260
Hospital Charge Code	32309
Hospital Revenue Code	637
Min. Negotiated Rate	$20.16
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 Commercial	$35.28
Rate for Payer: Cofinity Commercial	$43.34
Rate for Payer: Cofinity Medicare Advantage	$35.28
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: PHP Commercial	$42.84
Rate for Payer: Priority Health Cigna Priority Health	$32.76
Rate for Payer: Priority Health SBD	$31.75

VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION

Facility

$17.66

Service Code	NDC 70756060525
Hospital Charge Code	8527
Hospital Revenue Code	250
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$15.89
Rate for Payer: Aetna Commercial	$15.01
Rate for Payer: Aetna Medicare	$8.83
Rate for Payer: Aetna New Business (MI Preferred)	$11.48
Rate for Payer: BCBS Complete	$7.06
Rate for Payer: Cash Price	$14.13
Rate for Payer: Cofinity Commercial	$12.36
Rate for Payer: Cofinity Commercial	$15.19
Rate for Payer: Cofinity Medicare Advantage	$12.36
Rate for Payer: Encore Health Key Benefits Commercial	$14.13
Rate for Payer: Healthscope Commercial	$15.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.01
Rate for Payer: PHP Commercial	$15.01
Rate for Payer: Priority Health Cigna Priority Health	$11.48
Rate for Payer: Priority Health SBD	$11.13

VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION

Facility

$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 Commercial	$16.26
Rate for Payer: Cofinity Commercial	$19.98
Rate for Payer: Cofinity Medicare Advantage	$16.26
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: PHP Commercial	$19.75
Rate for Payer: Priority Health Cigna Priority Health	$15.10
Rate for Payer: Priority Health SBD	$14.63

VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION

Facility

$18.27

Service Code	NDC 70756060582
Hospital Charge Code	8527
Hospital Revenue Code	250
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$16.44
Rate for Payer: Aetna Commercial	$15.53
Rate for Payer: Aetna Medicare	$9.14
Rate for Payer: Aetna New Business (MI Preferred)	$11.88
Rate for Payer: BCBS Complete	$7.31
Rate for Payer: Cash Price	$14.62
Rate for Payer: Cofinity Commercial	$12.79
Rate for Payer: Cofinity Commercial	$15.71
Rate for Payer: Cofinity Medicare Advantage	$12.79
Rate for Payer: Encore Health Key Benefits Commercial	$14.62
Rate for Payer: Healthscope Commercial	$16.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.53
Rate for Payer: PHP Commercial	$15.53
Rate for Payer: Priority Health Cigna Priority Health	$11.88
Rate for Payer: Priority Health SBD	$11.51

Know your out-of-pocket cost for care.

All Charges