Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$24.04

Service Code	NDC 70121157601
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$20.43
Rate for Payer: Aetna New Business (MI Preferred)	$15.63
Rate for Payer: Cash Price	$19.23
Rate for Payer: Cofinity Commercial	$16.83
Rate for Payer: Cofinity Commercial	$20.67
Rate for Payer: Cofinity Medicare Advantage	$16.83
Rate for Payer: Encore Health Key Benefits Commercial	$19.23
Rate for Payer: Healthscope Commercial	$21.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.43
Rate for Payer: PHP Commercial	$20.43
Rate for Payer: Priority Health Cigna Priority Health	$15.63
Rate for Payer: Priority Health SBD	$15.15

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.34

Service Code	NDC 67457085204
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$16.51
Rate for Payer: Aetna Commercial	$15.59
Rate for Payer: Aetna Medicare	$9.17
Rate for Payer: Aetna New Business (MI Preferred)	$11.92
Rate for Payer: BCBS Complete	$7.34
Rate for Payer: Cash Price	$14.67
Rate for Payer: Cofinity Commercial	$12.84
Rate for Payer: Cofinity Commercial	$15.77
Rate for Payer: Cofinity Medicare Advantage	$12.84
Rate for Payer: Encore Health Key Benefits Commercial	$14.67
Rate for Payer: Healthscope Commercial	$16.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.59
Rate for Payer: PHP Commercial	$15.59
Rate for Payer: Priority Health Cigna Priority Health	$11.92
Rate for Payer: Priority Health SBD	$11.55

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.34

Service Code	NDC 67457085204
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$16.51
Rate for Payer: Aetna Commercial	$15.59
Rate for Payer: Aetna New Business (MI Preferred)	$11.92
Rate for Payer: Cash Price	$14.67
Rate for Payer: Cofinity Commercial	$12.84
Rate for Payer: Cofinity Commercial	$15.77
Rate for Payer: Cofinity Medicare Advantage	$12.84
Rate for Payer: Encore Health Key Benefits Commercial	$14.67
Rate for Payer: Healthscope Commercial	$16.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.59
Rate for Payer: PHP Commercial	$15.59
Rate for Payer: Priority Health Cigna Priority Health	$11.92
Rate for Payer: Priority Health SBD	$11.55

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.34

Service Code	NDC 67457085200
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$16.51
Rate for Payer: Aetna Commercial	$15.59
Rate for Payer: Aetna Medicare	$9.17
Rate for Payer: Aetna New Business (MI Preferred)	$11.92
Rate for Payer: BCBS Complete	$7.34
Rate for Payer: Cash Price	$14.67
Rate for Payer: Cofinity Commercial	$12.84
Rate for Payer: Cofinity Commercial	$15.77
Rate for Payer: Cofinity Medicare Advantage	$12.84
Rate for Payer: Encore Health Key Benefits Commercial	$14.67
Rate for Payer: Healthscope Commercial	$16.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.59
Rate for Payer: PHP Commercial	$15.59
Rate for Payer: Priority Health Cigna Priority Health	$11.92
Rate for Payer: Priority Health SBD	$11.55

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$18.34

Service Code	NDC 67457085200
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$16.51
Rate for Payer: Aetna Commercial	$15.59
Rate for Payer: Aetna New Business (MI Preferred)	$11.92
Rate for Payer: Cash Price	$14.67
Rate for Payer: Cofinity Commercial	$12.84
Rate for Payer: Cofinity Commercial	$15.77
Rate for Payer: Cofinity Medicare Advantage	$12.84
Rate for Payer: Encore Health Key Benefits Commercial	$14.67
Rate for Payer: Healthscope Commercial	$16.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.59
Rate for Payer: PHP Commercial	$15.59
Rate for Payer: Priority Health Cigna Priority Health	$11.92
Rate for Payer: Priority Health SBD	$11.55

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$15.07

Service Code	NDC 43066099710
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$13.56
Rate for Payer: Aetna Commercial	$12.81
Rate for Payer: Aetna Medicare	$7.54
Rate for Payer: Aetna New Business (MI Preferred)	$9.80
Rate for Payer: BCBS Complete	$6.03
Rate for Payer: Cash Price	$12.06
Rate for Payer: Cofinity Commercial	$10.55
Rate for Payer: Cofinity Commercial	$12.96
Rate for Payer: Cofinity Medicare Advantage	$10.55
Rate for Payer: Encore Health Key Benefits Commercial	$12.06
Rate for Payer: Healthscope Commercial	$13.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.81
Rate for Payer: PHP Commercial	$12.81
Rate for Payer: Priority Health Cigna Priority Health	$9.80
Rate for Payer: Priority Health SBD	$9.49

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$15.07

Service Code	NDC 43066099710
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$13.56
Rate for Payer: Aetna Commercial	$12.81
Rate for Payer: Aetna New Business (MI Preferred)	$9.80
Rate for Payer: Cash Price	$12.06
Rate for Payer: Cofinity Commercial	$10.55
Rate for Payer: Cofinity Commercial	$12.96
Rate for Payer: Cofinity Medicare Advantage	$10.55
Rate for Payer: Encore Health Key Benefits Commercial	$12.06
Rate for Payer: Healthscope Commercial	$13.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.81
Rate for Payer: PHP Commercial	$12.81
Rate for Payer: Priority Health Cigna Priority Health	$9.80
Rate for Payer: Priority Health SBD	$9.49

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$15.07

Service Code	NDC 43066099701
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$13.56
Rate for Payer: Aetna Commercial	$12.81
Rate for Payer: Aetna Medicare	$7.54
Rate for Payer: Aetna New Business (MI Preferred)	$9.80
Rate for Payer: BCBS Complete	$6.03
Rate for Payer: Cash Price	$12.06
Rate for Payer: Cofinity Commercial	$10.55
Rate for Payer: Cofinity Commercial	$12.96
Rate for Payer: Cofinity Medicare Advantage	$10.55
Rate for Payer: Encore Health Key Benefits Commercial	$12.06
Rate for Payer: Healthscope Commercial	$13.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.81
Rate for Payer: PHP Commercial	$12.81
Rate for Payer: Priority Health Cigna Priority Health	$9.80
Rate for Payer: Priority Health SBD	$9.49

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$15.07

Service Code	NDC 43066099701
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$13.56
Rate for Payer: Aetna Commercial	$12.81
Rate for Payer: Aetna New Business (MI Preferred)	$9.80
Rate for Payer: Cash Price	$12.06
Rate for Payer: Cofinity Commercial	$10.55
Rate for Payer: Cofinity Commercial	$12.96
Rate for Payer: Cofinity Medicare Advantage	$10.55
Rate for Payer: Encore Health Key Benefits Commercial	$12.06
Rate for Payer: Healthscope Commercial	$13.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$12.81
Rate for Payer: PHP Commercial	$12.81
Rate for Payer: Priority Health Cigna Priority Health	$9.80
Rate for Payer: Priority Health SBD	$9.49

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$20.25

Service Code	NDC 36000016210
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$17.21
Rate for Payer: Aetna Medicare	$10.12
Rate for Payer: Aetna New Business (MI Preferred)	$13.16
Rate for Payer: BCBS Complete	$8.10
Rate for Payer: Cash Price	$16.20
Rate for Payer: Cofinity Commercial	$14.18
Rate for Payer: Cofinity Commercial	$17.41
Rate for Payer: Cofinity Medicare Advantage	$14.18
Rate for Payer: Encore Health Key Benefits Commercial	$16.20
Rate for Payer: Healthscope Commercial	$18.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.21
Rate for Payer: PHP Commercial	$17.21
Rate for Payer: Priority Health Cigna Priority Health	$13.16
Rate for Payer: Priority Health SBD	$12.76

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$20.25

Service Code	NDC 36000016210
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$12.76
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$17.21
Rate for Payer: Aetna New Business (MI Preferred)	$13.16
Rate for Payer: Cash Price	$16.20
Rate for Payer: Cofinity Commercial	$14.18
Rate for Payer: Cofinity Commercial	$17.41
Rate for Payer: Cofinity Medicare Advantage	$14.18
Rate for Payer: Encore Health Key Benefits Commercial	$16.20
Rate for Payer: Healthscope Commercial	$18.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$17.21
Rate for Payer: PHP Commercial	$17.21
Rate for Payer: Priority Health Cigna Priority Health	$13.16
Rate for Payer: Priority Health SBD	$12.76

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$74.59

Service Code	NDC 00703115303
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$67.13
Rate for Payer: Aetna Commercial	$63.40
Rate for Payer: Aetna Medicare	$37.30
Rate for Payer: Aetna New Business (MI Preferred)	$48.48
Rate for Payer: BCBS Complete	$29.84
Rate for Payer: Cash Price	$59.67
Rate for Payer: Cofinity Commercial	$52.21
Rate for Payer: Cofinity Commercial	$64.15
Rate for Payer: Cofinity Medicare Advantage	$52.21
Rate for Payer: Encore Health Key Benefits Commercial	$59.67
Rate for Payer: Healthscope Commercial	$67.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.40
Rate for Payer: PHP Commercial	$63.40
Rate for Payer: Priority Health Cigna Priority Health	$48.48
Rate for Payer: Priority Health SBD	$46.99

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$74.59

Service Code	NDC 00703115303
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$46.99
Max. Negotiated Rate	$67.13
Rate for Payer: Aetna Commercial	$63.40
Rate for Payer: Aetna New Business (MI Preferred)	$48.48
Rate for Payer: Cash Price	$59.67
Rate for Payer: Cofinity Commercial	$52.21
Rate for Payer: Cofinity Commercial	$64.15
Rate for Payer: Cofinity Medicare Advantage	$52.21
Rate for Payer: Encore Health Key Benefits Commercial	$59.67
Rate for Payer: Healthscope Commercial	$67.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.40
Rate for Payer: PHP Commercial	$63.40
Rate for Payer: Priority Health Cigna Priority Health	$48.48
Rate for Payer: Priority Health SBD	$46.99

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$74.59

Service Code	NDC 00703115301
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$67.13
Rate for Payer: Aetna Commercial	$63.40
Rate for Payer: Aetna Medicare	$37.30
Rate for Payer: Aetna New Business (MI Preferred)	$48.48
Rate for Payer: BCBS Complete	$29.84
Rate for Payer: Cash Price	$59.67
Rate for Payer: Cofinity Commercial	$52.21
Rate for Payer: Cofinity Commercial	$64.15
Rate for Payer: Cofinity Medicare Advantage	$52.21
Rate for Payer: Encore Health Key Benefits Commercial	$59.67
Rate for Payer: Healthscope Commercial	$67.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.40
Rate for Payer: PHP Commercial	$63.40
Rate for Payer: Priority Health Cigna Priority Health	$48.48
Rate for Payer: Priority Health SBD	$46.99

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$74.59

Service Code	NDC 00703115301
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$46.99
Max. Negotiated Rate	$67.13
Rate for Payer: Aetna Commercial	$63.40
Rate for Payer: Aetna New Business (MI Preferred)	$48.48
Rate for Payer: Cash Price	$59.67
Rate for Payer: Cofinity Commercial	$52.21
Rate for Payer: Cofinity Commercial	$64.15
Rate for Payer: Cofinity Medicare Advantage	$52.21
Rate for Payer: Encore Health Key Benefits Commercial	$59.67
Rate for Payer: Healthscope Commercial	$67.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.40
Rate for Payer: PHP Commercial	$63.40
Rate for Payer: Priority Health Cigna Priority Health	$48.48
Rate for Payer: Priority Health SBD	$46.99

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$23.59

Service Code	NDC 00409337504
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$21.23
Rate for Payer: Aetna Commercial	$20.05
Rate for Payer: Aetna Medicare	$11.79
Rate for Payer: Aetna New Business (MI Preferred)	$15.33
Rate for Payer: BCBS Complete	$9.44
Rate for Payer: Cash Price	$18.87
Rate for Payer: Cofinity Commercial	$16.51
Rate for Payer: Cofinity Commercial	$20.29
Rate for Payer: Cofinity Medicare Advantage	$16.51
Rate for Payer: Encore Health Key Benefits Commercial	$18.87
Rate for Payer: Healthscope Commercial	$21.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.05
Rate for Payer: PHP Commercial	$20.05
Rate for Payer: Priority Health Cigna Priority Health	$15.33
Rate for Payer: Priority Health SBD	$14.86

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$23.59

Service Code	NDC 00409337504
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$14.86
Max. Negotiated Rate	$21.23
Rate for Payer: Aetna Commercial	$20.05
Rate for Payer: Aetna New Business (MI Preferred)	$15.33
Rate for Payer: Cash Price	$18.87
Rate for Payer: Cofinity Commercial	$16.51
Rate for Payer: Cofinity Commercial	$20.29
Rate for Payer: Cofinity Medicare Advantage	$16.51
Rate for Payer: Encore Health Key Benefits Commercial	$18.87
Rate for Payer: Healthscope Commercial	$21.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$20.05
Rate for Payer: PHP Commercial	$20.05
Rate for Payer: Priority Health Cigna Priority Health	$15.33
Rate for Payer: Priority Health SBD	$14.86

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$25.46

Service Code	NDC 00143931810
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$10.18
Max. Negotiated Rate	$22.91
Rate for Payer: Aetna Commercial	$21.64
Rate for Payer: Aetna Medicare	$12.73
Rate for Payer: Aetna New Business (MI Preferred)	$16.55
Rate for Payer: BCBS Complete	$10.18
Rate for Payer: Cash Price	$20.37
Rate for Payer: Cofinity Commercial	$17.82
Rate for Payer: Cofinity Commercial	$21.90
Rate for Payer: Cofinity Medicare Advantage	$17.82
Rate for Payer: Encore Health Key Benefits Commercial	$20.37
Rate for Payer: Healthscope Commercial	$22.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.64
Rate for Payer: PHP Commercial	$21.64
Rate for Payer: Priority Health Cigna Priority Health	$16.55
Rate for Payer: Priority Health SBD	$16.04

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$25.46

Service Code	NDC 00143931810
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$22.91
Rate for Payer: Aetna Commercial	$21.64
Rate for Payer: Aetna New Business (MI Preferred)	$16.55
Rate for Payer: Cash Price	$20.37
Rate for Payer: Cofinity Commercial	$17.82
Rate for Payer: Cofinity Commercial	$21.90
Rate for Payer: Cofinity Medicare Advantage	$17.82
Rate for Payer: Encore Health Key Benefits Commercial	$20.37
Rate for Payer: Healthscope Commercial	$22.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.64
Rate for Payer: PHP Commercial	$21.64
Rate for Payer: Priority Health Cigna Priority Health	$16.55
Rate for Payer: Priority Health SBD	$16.04

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION

Facility

$25.46

Service Code	NDC 00143931801
Hospital Charge Code	10734
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$22.91
Rate for Payer: Aetna Commercial	$21.64
Rate for Payer: Aetna New Business (MI Preferred)	$16.55
Rate for Payer: Cash Price	$20.37
Rate for Payer: Cofinity Commercial	$17.82
Rate for Payer: Cofinity Commercial	$21.90
Rate for Payer: Cofinity Medicare Advantage	$17.82
Rate for Payer: Encore Health Key Benefits Commercial	$20.37
Rate for Payer: Healthscope Commercial	$22.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$21.64
Rate for Payer: PHP Commercial	$21.64
Rate for Payer: Priority Health Cigna Priority Health	$16.55
Rate for Payer: Priority Health SBD	$16.04

NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION

Facility

$28.25

Service Code	NDC 44567064101
Hospital Charge Code	119763
Hospital Revenue Code	250
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna New Business (MI Preferred)	$18.36
Rate for Payer: Cash Price	$22.60
Rate for Payer: Cofinity Commercial	$19.77
Rate for Payer: Cofinity Commercial	$24.30
Rate for Payer: Cofinity Medicare Advantage	$19.77
Rate for Payer: Encore Health Key Benefits Commercial	$22.60
Rate for Payer: Healthscope Commercial	$25.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.01
Rate for Payer: PHP Commercial	$24.01
Rate for Payer: Priority Health Cigna Priority Health	$18.36
Rate for Payer: Priority Health SBD	$17.80

NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION

Facility

$28.25

Service Code	NDC 44567064101
Hospital Charge Code	119763
Hospital Revenue Code	250
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna Medicare	$14.12
Rate for Payer: Aetna New Business (MI Preferred)	$18.36
Rate for Payer: BCBS Complete	$11.30
Rate for Payer: Cash Price	$22.60
Rate for Payer: Cofinity Commercial	$19.77
Rate for Payer: Cofinity Commercial	$24.30
Rate for Payer: Cofinity Medicare Advantage	$19.77
Rate for Payer: Encore Health Key Benefits Commercial	$22.60
Rate for Payer: Healthscope Commercial	$25.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.01
Rate for Payer: PHP Commercial	$24.01
Rate for Payer: Priority Health Cigna Priority Health	$18.36
Rate for Payer: Priority Health SBD	$17.80

NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION

Facility

$28.25

Service Code	NDC 44567064110
Hospital Charge Code	119763
Hospital Revenue Code	250
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna Medicare	$14.12
Rate for Payer: Aetna New Business (MI Preferred)	$18.36
Rate for Payer: BCBS Complete	$11.30
Rate for Payer: Cash Price	$22.60
Rate for Payer: Cofinity Commercial	$19.77
Rate for Payer: Cofinity Commercial	$24.30
Rate for Payer: Cofinity Medicare Advantage	$19.77
Rate for Payer: Encore Health Key Benefits Commercial	$22.60
Rate for Payer: Healthscope Commercial	$25.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.01
Rate for Payer: PHP Commercial	$24.01
Rate for Payer: Priority Health Cigna Priority Health	$18.36
Rate for Payer: Priority Health SBD	$17.80

NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION

Facility

$28.25

Service Code	NDC 44567064110
Hospital Charge Code	119763
Hospital Revenue Code	250
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna New Business (MI Preferred)	$18.36
Rate for Payer: Cash Price	$22.60
Rate for Payer: Cofinity Commercial	$19.77
Rate for Payer: Cofinity Commercial	$24.30
Rate for Payer: Cofinity Medicare Advantage	$19.77
Rate for Payer: Encore Health Key Benefits Commercial	$22.60
Rate for Payer: Healthscope Commercial	$25.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.01
Rate for Payer: PHP Commercial	$24.01
Rate for Payer: Priority Health Cigna Priority Health	$18.36
Rate for Payer: Priority Health SBD	$17.80

NORTRIPTYLINE 10 MG CAPSULE

Facility

$173.38

Service Code	NDC 50268060315
Hospital Charge Code	5674
Hospital Revenue Code	637
Min. Negotiated Rate	$109.23
Max. Negotiated Rate	$156.04
Rate for Payer: Aetna Commercial	$147.37
Rate for Payer: Aetna New Business (MI Preferred)	$112.70
Rate for Payer: Cash Price	$138.70
Rate for Payer: Cofinity Commercial	$121.37
Rate for Payer: Cofinity Commercial	$149.11
Rate for Payer: Cofinity Medicare Advantage	$121.37
Rate for Payer: Encore Health Key Benefits Commercial	$138.70
Rate for Payer: Healthscope Commercial	$156.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$147.37
Rate for Payer: PHP Commercial	$147.37
Rate for Payer: Priority Health Cigna Priority Health	$112.70
Rate for Payer: Priority Health SBD	$109.23

Know your out-of-pocket cost for care.

All Charges