|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$504.00
|
|
|
Service Code
|
NDC 00904679480
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$350.78 |
| Max. Negotiated Rate |
$453.60 |
| Rate for Payer: Aetna Commercial |
$428.40
|
| Rate for Payer: BCBS Trust/PPO |
$416.25
|
| Rate for Payer: BCN Commercial |
$416.25
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cofinity Commercial |
$433.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.20
|
| Rate for Payer: Healthscope Commercial |
$453.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.40
|
| Rate for Payer: Nomi Health Commercial |
$413.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.00
|
| Rate for Payer: PHP Commercial |
$428.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.52
|
| Rate for Payer: UHC Core |
$420.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.00
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$676.50
|
|
|
Service Code
|
NDC 66553000201
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$470.84 |
| Max. Negotiated Rate |
$608.85 |
| Rate for Payer: Aetna Commercial |
$575.02
|
| Rate for Payer: BCBS Trust/PPO |
$558.72
|
| Rate for Payer: BCN Commercial |
$558.72
|
| Rate for Payer: Cash Price |
$541.20
|
| Rate for Payer: Cofinity Commercial |
$581.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.20
|
| Rate for Payer: Healthscope Commercial |
$608.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$575.02
|
| Rate for Payer: Nomi Health Commercial |
$554.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.38
|
| Rate for Payer: PHP Commercial |
$575.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$588.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.32
|
| Rate for Payer: UHC Core |
$564.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.38
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$756.00
|
|
|
Service Code
|
NDC 63739043402
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$526.18 |
| Max. Negotiated Rate |
$680.40 |
| Rate for Payer: Aetna Commercial |
$642.60
|
| Rate for Payer: BCBS Trust/PPO |
$624.38
|
| Rate for Payer: BCN Commercial |
$624.38
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$650.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.80
|
| Rate for Payer: Healthscope Commercial |
$680.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$567.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.60
|
| Rate for Payer: Nomi Health Commercial |
$619.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.00
|
| Rate for Payer: PHP Commercial |
$642.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$657.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.28
|
| Rate for Payer: UHC Core |
$631.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$567.00
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
OP
|
$174.90
|
|
|
Service Code
|
NDC 77333004920
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.83 |
| Max. Negotiated Rate |
$157.41 |
| Rate for Payer: Aetna Commercial |
$148.66
|
| Rate for Payer: Aetna Medicare |
$45.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.66
|
| Rate for Payer: BCBS Complete |
$32.37
|
| Rate for Payer: BCBS MAPPO |
$43.73
|
| Rate for Payer: BCBS Trust/PPO |
$143.79
|
| Rate for Payer: BCN Commercial |
$143.79
|
| Rate for Payer: BCN Medicare Advantage |
$43.73
|
| Rate for Payer: Cash Price |
$139.92
|
| Rate for Payer: Cofinity Commercial |
$150.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.73
|
| Rate for Payer: Healthscope Commercial |
$157.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.18
|
| Rate for Payer: Mclaren Medicaid |
$30.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.91
|
| Rate for Payer: Meridian Medicaid |
$32.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.66
|
| Rate for Payer: Nomi Health Commercial |
$143.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.18
|
| Rate for Payer: PACE Senior Care Partners |
$41.54
|
| Rate for Payer: PACE SWMI |
$43.73
|
| Rate for Payer: PHP Commercial |
$148.66
|
| Rate for Payer: PHP Medicare Advantage |
$43.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$152.16
|
| Rate for Payer: Priority Health Medicare |
$44.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.73
|
| Rate for Payer: Railroad Medicare Medicare |
$43.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.91
|
| Rate for Payer: UHC Core |
$146.04
|
| Rate for Payer: UHC Exchange |
$43.73
|
| Rate for Payer: UHC Medicaid |
$30.83
|
| Rate for Payer: UHC Medicare Advantage |
$43.73
|
| Rate for Payer: UHCCP Medicaid |
$30.83
|
| Rate for Payer: VA VA |
$43.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.18
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
NDC 16103036611
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.43 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna Commercial |
$214.20
|
| Rate for Payer: Aetna Medicare |
$65.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.75
|
| Rate for Payer: BCBS Complete |
$46.65
|
| Rate for Payer: BCBS MAPPO |
$63.00
|
| Rate for Payer: BCBS Trust/PPO |
$207.17
|
| Rate for Payer: BCN Commercial |
$207.17
|
| Rate for Payer: BCN Medicare Advantage |
$63.00
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$216.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.00
|
| Rate for Payer: Healthscope Commercial |
$226.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.00
|
| Rate for Payer: Mclaren Medicaid |
$44.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.15
|
| Rate for Payer: Meridian Medicaid |
$46.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.20
|
| Rate for Payer: Nomi Health Commercial |
$206.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PACE Senior Care Partners |
$59.85
|
| Rate for Payer: PACE SWMI |
$63.00
|
| Rate for Payer: PHP Commercial |
$214.20
|
| Rate for Payer: PHP Medicare Advantage |
$63.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.24
|
| Rate for Payer: Priority Health Medicare |
$63.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.39
|
| Rate for Payer: Railroad Medicare Medicare |
$63.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.76
|
| Rate for Payer: UHC Core |
$210.42
|
| Rate for Payer: UHC Exchange |
$63.00
|
| Rate for Payer: UHC Medicaid |
$44.43
|
| Rate for Payer: UHC Medicare Advantage |
$63.00
|
| Rate for Payer: UHCCP Medicaid |
$44.43
|
| Rate for Payer: VA VA |
$63.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.00
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
OP
|
$1.17
|
|
|
Service Code
|
NDC 77333004925
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Aetna Commercial |
$0.99
|
| Rate for Payer: Aetna Medicare |
$0.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.37
|
| Rate for Payer: BCBS Complete |
$0.22
|
| Rate for Payer: BCBS MAPPO |
$0.29
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: BCN Medicare Advantage |
$0.29
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cofinity Commercial |
$1.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.29
|
| Rate for Payer: Healthscope Commercial |
$1.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.88
|
| Rate for Payer: Mclaren Medicaid |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.31
|
| Rate for Payer: Meridian Medicaid |
$0.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.88
|
| Rate for Payer: PACE Senior Care Partners |
$0.28
|
| Rate for Payer: PACE SWMI |
$0.29
|
| Rate for Payer: PHP Commercial |
$0.99
|
| Rate for Payer: PHP Medicare Advantage |
$0.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.02
|
| Rate for Payer: Priority Health Medicare |
$0.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.81
|
| Rate for Payer: Railroad Medicare Medicare |
$0.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.03
|
| Rate for Payer: UHC Core |
$0.98
|
| Rate for Payer: UHC Exchange |
$0.29
|
| Rate for Payer: UHC Medicaid |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.29
|
| Rate for Payer: UHCCP Medicaid |
$0.21
|
| Rate for Payer: VA VA |
$0.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.88
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
NDC 16103036611
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.39 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna Commercial |
$214.20
|
| Rate for Payer: BCBS Trust/PPO |
$208.13
|
| Rate for Payer: BCN Commercial |
$208.13
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$216.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Healthscope Commercial |
$226.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.20
|
| Rate for Payer: Nomi Health Commercial |
$206.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PHP Commercial |
$214.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.76
|
| Rate for Payer: UHC Core |
$210.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.00
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$174.90
|
|
|
Service Code
|
NDC 77333004920
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.73 |
| Max. Negotiated Rate |
$157.41 |
| Rate for Payer: Aetna Commercial |
$148.66
|
| Rate for Payer: BCBS Trust/PPO |
$144.45
|
| Rate for Payer: BCN Commercial |
$144.45
|
| Rate for Payer: Cash Price |
$139.92
|
| Rate for Payer: Cofinity Commercial |
$150.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.92
|
| Rate for Payer: Healthscope Commercial |
$157.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.66
|
| Rate for Payer: Nomi Health Commercial |
$143.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.18
|
| Rate for Payer: PHP Commercial |
$148.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$152.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.91
|
| Rate for Payer: UHC Core |
$146.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.18
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
IP
|
$90.72
|
|
|
Service Code
|
NDC 00904679489
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.14 |
| Max. Negotiated Rate |
$81.65 |
| Rate for Payer: Aetna Commercial |
$77.11
|
| Rate for Payer: BCBS Trust/PPO |
$74.93
|
| Rate for Payer: BCN Commercial |
$74.93
|
| Rate for Payer: Cash Price |
$72.58
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.58
|
| Rate for Payer: Healthscope Commercial |
$81.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.11
|
| Rate for Payer: Nomi Health Commercial |
$74.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.04
|
| Rate for Payer: PHP Commercial |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.83
|
| Rate for Payer: UHC Core |
$75.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.04
|
|
|
ASPIRIN 81 MG CHEWABLE TABLET
|
Facility
|
OP
|
$676.50
|
|
|
Service Code
|
NDC 66553000201
|
| Hospital Charge Code |
679
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.27 |
| Max. Negotiated Rate |
$608.85 |
| Rate for Payer: Aetna Commercial |
$575.02
|
| Rate for Payer: Aetna Medicare |
$175.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.41
|
| Rate for Payer: BCBS Complete |
$125.22
|
| Rate for Payer: BCBS MAPPO |
$169.12
|
| Rate for Payer: BCBS Trust/PPO |
$556.15
|
| Rate for Payer: BCN Commercial |
$556.15
|
| Rate for Payer: BCN Medicare Advantage |
$169.12
|
| Rate for Payer: Cash Price |
$541.20
|
| Rate for Payer: Cofinity Commercial |
$581.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.12
|
| Rate for Payer: Healthscope Commercial |
$608.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.38
|
| Rate for Payer: Mclaren Medicaid |
$119.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.58
|
| Rate for Payer: Meridian Medicaid |
$125.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$575.02
|
| Rate for Payer: Nomi Health Commercial |
$554.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.38
|
| Rate for Payer: PACE Senior Care Partners |
$160.67
|
| Rate for Payer: PACE SWMI |
$169.12
|
| Rate for Payer: PHP Commercial |
$575.02
|
| Rate for Payer: PHP Medicare Advantage |
$169.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$588.55
|
| Rate for Payer: Priority Health Medicare |
$170.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.84
|
| Rate for Payer: Railroad Medicare Medicare |
$169.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.32
|
| Rate for Payer: UHC Core |
$564.88
|
| Rate for Payer: UHC Exchange |
$169.12
|
| Rate for Payer: UHC Medicaid |
$119.27
|
| Rate for Payer: UHC Medicare Advantage |
$169.12
|
| Rate for Payer: UHCCP Medicaid |
$119.27
|
| Rate for Payer: VA VA |
$169.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.38
|
|
|
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET
|
Facility
|
IP
|
$61.10
|
|
|
Service Code
|
NDC 09629513158
|
| Hospital Charge Code |
9158
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.53 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Aetna Commercial |
$51.94
|
| Rate for Payer: BCBS Trust/PPO |
$50.46
|
| Rate for Payer: BCN Commercial |
$50.46
|
| Rate for Payer: Cash Price |
$48.88
|
| Rate for Payer: Cofinity Commercial |
$52.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.88
|
| Rate for Payer: Healthscope Commercial |
$54.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.94
|
| Rate for Payer: Nomi Health Commercial |
$50.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.83
|
| Rate for Payer: PHP Commercial |
$51.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.77
|
| Rate for Payer: UHC Core |
$51.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.83
|
|
|
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET
|
Facility
|
OP
|
$70.50
|
|
|
Service Code
|
NDC 00536132601
|
| Hospital Charge Code |
9158
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$63.45 |
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: Aetna Medicare |
$18.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.03
|
| Rate for Payer: BCBS Complete |
$13.05
|
| Rate for Payer: BCBS MAPPO |
$17.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.62
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.62
|
| Rate for Payer: Healthscope Commercial |
$63.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.88
|
| Rate for Payer: Mclaren Medicaid |
$12.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.51
|
| Rate for Payer: Meridian Medicaid |
$13.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.92
|
| Rate for Payer: Nomi Health Commercial |
$57.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.88
|
| Rate for Payer: PACE Senior Care Partners |
$16.74
|
| Rate for Payer: PACE SWMI |
$17.62
|
| Rate for Payer: PHP Commercial |
$59.92
|
| Rate for Payer: PHP Medicare Advantage |
$17.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.34
|
| Rate for Payer: Priority Health Medicare |
$17.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: Railroad Medicare Medicare |
$17.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.04
|
| Rate for Payer: UHC Core |
$58.87
|
| Rate for Payer: UHC Exchange |
$17.62
|
| Rate for Payer: UHC Medicaid |
$12.43
|
| Rate for Payer: UHC Medicare Advantage |
$17.62
|
| Rate for Payer: UHCCP Medicaid |
$12.43
|
| Rate for Payer: VA VA |
$17.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.88
|
|
|
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET
|
Facility
|
IP
|
$70.50
|
|
|
Service Code
|
NDC 00536132601
|
| Hospital Charge Code |
9158
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.07 |
| Max. Negotiated Rate |
$63.45 |
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: BCBS Trust/PPO |
$58.23
|
| Rate for Payer: BCN Commercial |
$58.23
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$63.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.92
|
| Rate for Payer: Nomi Health Commercial |
$57.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.88
|
| Rate for Payer: PHP Commercial |
$59.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.04
|
| Rate for Payer: UHC Core |
$58.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.88
|
|
|
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET
|
Facility
|
OP
|
$61.10
|
|
|
Service Code
|
NDC 09629513158
|
| Hospital Charge Code |
9158
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Aetna Commercial |
$51.94
|
| Rate for Payer: Aetna Medicare |
$15.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.09
|
| Rate for Payer: BCBS Complete |
$11.31
|
| Rate for Payer: BCBS MAPPO |
$15.28
|
| Rate for Payer: BCBS Trust/PPO |
$50.23
|
| Rate for Payer: BCN Commercial |
$50.23
|
| Rate for Payer: BCN Medicare Advantage |
$15.28
|
| Rate for Payer: Cash Price |
$48.88
|
| Rate for Payer: Cofinity Commercial |
$52.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$54.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.83
|
| Rate for Payer: Mclaren Medicaid |
$10.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.04
|
| Rate for Payer: Meridian Medicaid |
$11.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.94
|
| Rate for Payer: Nomi Health Commercial |
$50.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.83
|
| Rate for Payer: PACE Senior Care Partners |
$14.51
|
| Rate for Payer: PACE SWMI |
$15.28
|
| Rate for Payer: PHP Commercial |
$51.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.16
|
| Rate for Payer: Priority Health Medicare |
$15.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.53
|
| Rate for Payer: Railroad Medicare Medicare |
$15.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.77
|
| Rate for Payer: UHC Core |
$51.02
|
| Rate for Payer: UHC Exchange |
$15.28
|
| Rate for Payer: UHC Medicaid |
$10.77
|
| Rate for Payer: UHC Medicare Advantage |
$15.28
|
| Rate for Payer: UHCCP Medicaid |
$10.77
|
| Rate for Payer: VA VA |
$15.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.83
|
|
|
ASTHMA
|
Facility
|
IP
|
$10,310.14
|
|
|
Service Code
|
APR-DRG 1414
|
| Min. Negotiated Rate |
$9,819.19 |
| Max. Negotiated Rate |
$10,310.14 |
| Rate for Payer: BCBS Complete |
$10,310.14
|
| Rate for Payer: Mclaren Medicaid |
$9,819.19
|
| Rate for Payer: Meridian Medicaid |
$10,310.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,819.19
|
| Rate for Payer: UHC Medicaid |
$9,819.19
|
| Rate for Payer: UHCCP Medicaid |
$9,819.19
|
|
|
ASTHMA
|
Facility
|
IP
|
$3,760.28
|
|
|
Service Code
|
APR-DRG 1412
|
| Min. Negotiated Rate |
$3,581.22 |
| Max. Negotiated Rate |
$3,760.28 |
| Rate for Payer: BCBS Complete |
$3,760.28
|
| Rate for Payer: Mclaren Medicaid |
$3,581.22
|
| Rate for Payer: Meridian Medicaid |
$3,760.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,581.22
|
| Rate for Payer: UHC Medicaid |
$3,581.22
|
| Rate for Payer: UHCCP Medicaid |
$3,581.22
|
|
|
ASTHMA
|
Facility
|
IP
|
$2,868.46
|
|
|
Service Code
|
APR-DRG 1411
|
| Min. Negotiated Rate |
$2,731.86 |
| Max. Negotiated Rate |
$2,868.46 |
| Rate for Payer: BCBS Complete |
$2,868.46
|
| Rate for Payer: Mclaren Medicaid |
$2,731.86
|
| Rate for Payer: Meridian Medicaid |
$2,868.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,731.86
|
| Rate for Payer: UHC Medicaid |
$2,731.86
|
| Rate for Payer: UHCCP Medicaid |
$2,731.86
|
|
|
ASTHMA
|
Facility
|
IP
|
$5,256.30
|
|
|
Service Code
|
APR-DRG 1413
|
| Min. Negotiated Rate |
$5,006.00 |
| Max. Negotiated Rate |
$5,256.30 |
| Rate for Payer: BCBS Complete |
$5,256.30
|
| Rate for Payer: Mclaren Medicaid |
$5,006.00
|
| Rate for Payer: Meridian Medicaid |
$5,256.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,006.00
|
| Rate for Payer: UHC Medicaid |
$5,006.00
|
| Rate for Payer: UHCCP Medicaid |
$5,006.00
|
|
|
ATENOLOL 12.5 MG CUSTOM TAB
|
Facility
|
IP
|
$1.39
|
|
|
Service Code
|
NDC 09900000308
|
| Hospital Charge Code |
155119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Aetna Commercial |
$1.18
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: Cash Price |
$1.11
|
| Rate for Payer: Cofinity Commercial |
$1.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.11
|
| Rate for Payer: Healthscope Commercial |
$1.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.18
|
| Rate for Payer: Nomi Health Commercial |
$1.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.04
|
| Rate for Payer: PHP Commercial |
$1.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.22
|
| Rate for Payer: UHC Core |
$1.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.04
|
|
|
ATENOLOL 12.5 MG CUSTOM TAB
|
Facility
|
OP
|
$1.39
|
|
|
Service Code
|
NDC 09900000308
|
| Hospital Charge Code |
155119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Aetna Commercial |
$1.18
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.43
|
| Rate for Payer: BCBS Complete |
$0.26
|
| Rate for Payer: BCBS MAPPO |
$0.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.14
|
| Rate for Payer: BCN Commercial |
$1.14
|
| Rate for Payer: BCN Medicare Advantage |
$0.35
|
| Rate for Payer: Cash Price |
$1.11
|
| Rate for Payer: Cofinity Commercial |
$1.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.35
|
| Rate for Payer: Healthscope Commercial |
$1.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.04
|
| Rate for Payer: Mclaren Medicaid |
$0.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.36
|
| Rate for Payer: Meridian Medicaid |
$0.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.18
|
| Rate for Payer: Nomi Health Commercial |
$1.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.04
|
| Rate for Payer: PACE Senior Care Partners |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.35
|
| Rate for Payer: PHP Commercial |
$1.18
|
| Rate for Payer: PHP Medicare Advantage |
$0.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.21
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.97
|
| Rate for Payer: Railroad Medicare Medicare |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.22
|
| Rate for Payer: UHC Core |
$1.16
|
| Rate for Payer: UHC Exchange |
$0.35
|
| Rate for Payer: UHC Medicaid |
$0.25
|
| Rate for Payer: UHC Medicare Advantage |
$0.35
|
| Rate for Payer: UHCCP Medicaid |
$0.25
|
| Rate for Payer: VA VA |
$0.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.04
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
OP
|
$75.20
|
|
|
Service Code
|
NDC 00093078701
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$67.68 |
| Rate for Payer: Aetna Commercial |
$63.92
|
| Rate for Payer: Aetna Medicare |
$19.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.50
|
| Rate for Payer: BCBS Complete |
$13.92
|
| Rate for Payer: BCBS MAPPO |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$61.82
|
| Rate for Payer: BCN Commercial |
$61.82
|
| Rate for Payer: BCN Medicare Advantage |
$18.80
|
| Rate for Payer: Cash Price |
$60.16
|
| Rate for Payer: Cofinity Commercial |
$64.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.80
|
| Rate for Payer: Healthscope Commercial |
$67.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.40
|
| Rate for Payer: Mclaren Medicaid |
$13.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.74
|
| Rate for Payer: Meridian Medicaid |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.92
|
| Rate for Payer: Nomi Health Commercial |
$61.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.40
|
| Rate for Payer: PACE Senior Care Partners |
$17.86
|
| Rate for Payer: PACE SWMI |
$18.80
|
| Rate for Payer: PHP Commercial |
$63.92
|
| Rate for Payer: PHP Medicare Advantage |
$18.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.42
|
| Rate for Payer: Priority Health Medicare |
$18.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.34
|
| Rate for Payer: Railroad Medicare Medicare |
$18.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.18
|
| Rate for Payer: UHC Core |
$62.79
|
| Rate for Payer: UHC Exchange |
$18.80
|
| Rate for Payer: UHC Medicaid |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$18.80
|
| Rate for Payer: UHCCP Medicaid |
$13.26
|
| Rate for Payer: VA VA |
$18.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.40
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
OP
|
$404.20
|
|
|
Service Code
|
NDC 51079075920
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.26 |
| Max. Negotiated Rate |
$363.78 |
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Medicare |
$105.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.31
|
| Rate for Payer: BCBS Complete |
$74.82
|
| Rate for Payer: BCBS MAPPO |
$101.05
|
| Rate for Payer: BCBS Trust/PPO |
$332.29
|
| Rate for Payer: BCN Commercial |
$332.29
|
| Rate for Payer: BCN Medicare Advantage |
$101.05
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.05
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Mclaren Medicaid |
$71.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.10
|
| Rate for Payer: Meridian Medicaid |
$74.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: Nomi Health Commercial |
$331.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.15
|
| Rate for Payer: PACE Senior Care Partners |
$96.00
|
| Rate for Payer: PACE SWMI |
$101.05
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: PHP Medicare Advantage |
$101.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.65
|
| Rate for Payer: Priority Health Medicare |
$102.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.32
|
| Rate for Payer: Railroad Medicare Medicare |
$101.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.70
|
| Rate for Payer: UHC Core |
$337.51
|
| Rate for Payer: UHC Exchange |
$101.05
|
| Rate for Payer: UHC Medicaid |
$71.26
|
| Rate for Payer: UHC Medicare Advantage |
$101.05
|
| Rate for Payer: UHCCP Medicaid |
$71.26
|
| Rate for Payer: VA VA |
$101.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
IP
|
$75.20
|
|
|
Service Code
|
NDC 00093078701
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$67.68 |
| Rate for Payer: Aetna Commercial |
$63.92
|
| Rate for Payer: BCBS Trust/PPO |
$62.11
|
| Rate for Payer: BCN Commercial |
$62.11
|
| Rate for Payer: Cash Price |
$60.16
|
| Rate for Payer: Cofinity Commercial |
$64.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.16
|
| Rate for Payer: Healthscope Commercial |
$67.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.92
|
| Rate for Payer: Nomi Health Commercial |
$61.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.40
|
| Rate for Payer: PHP Commercial |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.18
|
| Rate for Payer: UHC Core |
$62.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.40
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
OP
|
$354.85
|
|
|
Service Code
|
NDC 00904718761
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.56 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: Aetna Medicare |
$92.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.89
|
| Rate for Payer: BCBS Complete |
$65.68
|
| Rate for Payer: BCBS MAPPO |
$88.71
|
| Rate for Payer: BCBS Trust/PPO |
$291.72
|
| Rate for Payer: BCN Commercial |
$291.72
|
| Rate for Payer: BCN Medicare Advantage |
$88.71
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.71
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: Mclaren Medicaid |
$62.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.15
|
| Rate for Payer: Meridian Medicaid |
$65.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Nomi Health Commercial |
$290.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PACE Senior Care Partners |
$84.28
|
| Rate for Payer: PACE SWMI |
$88.71
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: PHP Medicare Advantage |
$88.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.72
|
| Rate for Payer: Priority Health Medicare |
$89.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.98
|
| Rate for Payer: Railroad Medicare Medicare |
$88.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.27
|
| Rate for Payer: UHC Core |
$296.30
|
| Rate for Payer: UHC Exchange |
$88.71
|
| Rate for Payer: UHC Medicaid |
$62.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.71
|
| Rate for Payer: UHCCP Medicaid |
$62.56
|
| Rate for Payer: VA VA |
$88.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
IP
|
$4.05
|
|
|
Service Code
|
NDC 51079075901
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$3.65 |
| Rate for Payer: Aetna Commercial |
$3.44
|
| Rate for Payer: BCBS Trust/PPO |
$3.34
|
| Rate for Payer: BCN Commercial |
$3.34
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cofinity Commercial |
$3.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.24
|
| Rate for Payer: Healthscope Commercial |
$3.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.44
|
| Rate for Payer: Nomi Health Commercial |
$3.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.04
|
| Rate for Payer: PHP Commercial |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC Core |
$3.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.04
|
|
