|
BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE
|
Facility
|
IP
|
$111.60
|
|
|
Service Code
|
NDC 10370010103
|
| Hospital Charge Code |
36775
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.67 |
| Max. Negotiated Rate |
$100.44 |
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: BCBS Trust/PPO |
$92.17
|
| Rate for Payer: BCN Commercial |
$92.17
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Nomi Health Commercial |
$91.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.70
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.21
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE
|
Facility
|
OP
|
$111.60
|
|
|
Service Code
|
NDC 10370010103
|
| Hospital Charge Code |
36775
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.68 |
| Max. Negotiated Rate |
$100.44 |
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: Aetna Medicare |
$29.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.88
|
| Rate for Payer: BCBS Complete |
$20.66
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$91.75
|
| Rate for Payer: BCN Commercial |
$91.75
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Mclaren Medicaid |
$19.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.30
|
| Rate for Payer: Meridian Medicaid |
$20.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Nomi Health Commercial |
$91.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.70
|
| Rate for Payer: PACE Senior Care Partners |
$26.50
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.09
|
| Rate for Payer: Priority Health Medicare |
$28.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.67
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.21
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: UHC Exchange |
$27.90
|
| Rate for Payer: UHC Medicaid |
$19.68
|
| Rate for Payer: UHC Medicare Advantage |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$19.68
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE
|
Facility
|
IP
|
$677.28
|
|
|
Service Code
|
NDC 00904750561
|
| Hospital Charge Code |
36775
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$471.39 |
| Max. Negotiated Rate |
$609.55 |
| Rate for Payer: Aetna Commercial |
$575.69
|
| Rate for Payer: BCBS Trust/PPO |
$559.37
|
| Rate for Payer: BCN Commercial |
$559.37
|
| Rate for Payer: Cash Price |
$541.82
|
| Rate for Payer: Cofinity Commercial |
$582.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.82
|
| Rate for Payer: Healthscope Commercial |
$609.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$575.69
|
| Rate for Payer: Nomi Health Commercial |
$555.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.96
|
| Rate for Payer: PHP Commercial |
$575.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$589.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.01
|
| Rate for Payer: UHC Core |
$565.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.96
|
|
|
BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE
|
Facility
|
OP
|
$361.67
|
|
|
Service Code
|
NDC 68180031909
|
| Hospital Charge Code |
36775
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.76 |
| Max. Negotiated Rate |
$325.50 |
| Rate for Payer: Aetna Commercial |
$307.42
|
| Rate for Payer: Aetna Medicare |
$94.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.02
|
| Rate for Payer: BCBS Complete |
$66.95
|
| Rate for Payer: BCBS MAPPO |
$90.42
|
| Rate for Payer: BCBS Trust/PPO |
$297.33
|
| Rate for Payer: BCN Commercial |
$297.33
|
| Rate for Payer: BCN Medicare Advantage |
$90.42
|
| Rate for Payer: Cash Price |
$289.34
|
| Rate for Payer: Cofinity Commercial |
$311.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.42
|
| Rate for Payer: Healthscope Commercial |
$325.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.25
|
| Rate for Payer: Mclaren Medicaid |
$63.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.94
|
| Rate for Payer: Meridian Medicaid |
$66.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.42
|
| Rate for Payer: Nomi Health Commercial |
$296.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.25
|
| Rate for Payer: PACE Senior Care Partners |
$85.90
|
| Rate for Payer: PACE SWMI |
$90.42
|
| Rate for Payer: PHP Commercial |
$307.42
|
| Rate for Payer: PHP Medicare Advantage |
$90.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$314.65
|
| Rate for Payer: Priority Health Medicare |
$91.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.72
|
| Rate for Payer: Railroad Medicare Medicare |
$90.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.27
|
| Rate for Payer: UHC Core |
$301.99
|
| Rate for Payer: UHC Exchange |
$90.42
|
| Rate for Payer: UHC Medicaid |
$63.76
|
| Rate for Payer: UHC Medicare Advantage |
$90.42
|
| Rate for Payer: UHCCP Medicaid |
$63.76
|
| Rate for Payer: VA VA |
$90.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.25
|
|
|
BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE
|
Facility
|
OP
|
$615.84
|
|
|
Service Code
|
NDC 00904708461
|
| Hospital Charge Code |
36775
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.57 |
| Max. Negotiated Rate |
$554.26 |
| Rate for Payer: Aetna Commercial |
$523.46
|
| Rate for Payer: Aetna Medicare |
$160.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.45
|
| Rate for Payer: BCBS Complete |
$113.99
|
| Rate for Payer: BCBS MAPPO |
$153.96
|
| Rate for Payer: BCBS Trust/PPO |
$506.28
|
| Rate for Payer: BCN Commercial |
$506.28
|
| Rate for Payer: BCN Medicare Advantage |
$153.96
|
| Rate for Payer: Cash Price |
$492.67
|
| Rate for Payer: Cofinity Commercial |
$529.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.96
|
| Rate for Payer: Healthscope Commercial |
$554.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$461.88
|
| Rate for Payer: Mclaren Medicaid |
$108.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.66
|
| Rate for Payer: Meridian Medicaid |
$113.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$169.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.46
|
| Rate for Payer: Nomi Health Commercial |
$504.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$461.88
|
| Rate for Payer: PACE Senior Care Partners |
$146.26
|
| Rate for Payer: PACE SWMI |
$153.96
|
| Rate for Payer: PHP Commercial |
$523.46
|
| Rate for Payer: PHP Medicare Advantage |
$153.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$535.78
|
| Rate for Payer: Priority Health Medicare |
$155.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$428.62
|
| Rate for Payer: Railroad Medicare Medicare |
$153.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.94
|
| Rate for Payer: UHC Core |
$514.23
|
| Rate for Payer: UHC Exchange |
$153.96
|
| Rate for Payer: UHC Medicaid |
$108.57
|
| Rate for Payer: UHC Medicare Advantage |
$153.96
|
| Rate for Payer: UHCCP Medicaid |
$108.57
|
| Rate for Payer: VA VA |
$153.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$461.88
|
|
|
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS
|
Facility
|
IP
|
$18,205.11
|
|
|
Service Code
|
APR-DRG 8422
|
| Min. Negotiated Rate |
$17,338.20 |
| Max. Negotiated Rate |
$18,205.11 |
| Rate for Payer: BCBS Complete |
$18,205.11
|
| Rate for Payer: Mclaren Medicaid |
$17,338.20
|
| Rate for Payer: Meridian Medicaid |
$18,205.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,338.20
|
| Rate for Payer: UHC Medicaid |
$17,338.20
|
| Rate for Payer: UHCCP Medicaid |
$17,338.20
|
|
|
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS
|
Facility
|
IP
|
$9,308.42
|
|
|
Service Code
|
APR-DRG 8421
|
| Min. Negotiated Rate |
$8,865.16 |
| Max. Negotiated Rate |
$9,308.42 |
| Rate for Payer: BCBS Complete |
$9,308.42
|
| Rate for Payer: Mclaren Medicaid |
$8,865.16
|
| Rate for Payer: Meridian Medicaid |
$9,308.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,865.16
|
| Rate for Payer: UHC Medicaid |
$8,865.16
|
| Rate for Payer: UHCCP Medicaid |
$8,865.16
|
|
|
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS
|
Facility
|
IP
|
$86,930.29
|
|
|
Service Code
|
APR-DRG 8424
|
| Min. Negotiated Rate |
$82,790.75 |
| Max. Negotiated Rate |
$86,930.29 |
| Rate for Payer: BCBS Complete |
$86,930.29
|
| Rate for Payer: Mclaren Medicaid |
$82,790.75
|
| Rate for Payer: Meridian Medicaid |
$86,930.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$82,790.75
|
| Rate for Payer: UHC Medicaid |
$82,790.75
|
| Rate for Payer: UHCCP Medicaid |
$82,790.75
|
|
|
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS
|
Facility
|
IP
|
$22,961.33
|
|
|
Service Code
|
APR-DRG 8423
|
| Min. Negotiated Rate |
$21,867.93 |
| Max. Negotiated Rate |
$22,961.33 |
| Rate for Payer: BCBS Complete |
$22,961.33
|
| Rate for Payer: Mclaren Medicaid |
$21,867.93
|
| Rate for Payer: Meridian Medicaid |
$22,961.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,867.93
|
| Rate for Payer: UHC Medicaid |
$21,867.93
|
| Rate for Payer: UHCCP Medicaid |
$21,867.93
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
OP
|
$426.55
|
|
|
Service Code
|
NDC 51079096020
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$383.89 |
| Rate for Payer: Aetna Commercial |
$362.57
|
| Rate for Payer: Aetna Medicare |
$110.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.30
|
| Rate for Payer: BCBS Complete |
$78.95
|
| Rate for Payer: BCBS MAPPO |
$106.64
|
| Rate for Payer: BCBS Trust/PPO |
$350.67
|
| Rate for Payer: BCN Commercial |
$350.67
|
| Rate for Payer: BCN Medicare Advantage |
$106.64
|
| Rate for Payer: Cash Price |
$341.24
|
| Rate for Payer: Cofinity Commercial |
$366.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.64
|
| Rate for Payer: Healthscope Commercial |
$383.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.91
|
| Rate for Payer: Mclaren Medicaid |
$75.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.97
|
| Rate for Payer: Meridian Medicaid |
$78.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.57
|
| Rate for Payer: Nomi Health Commercial |
$349.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.91
|
| Rate for Payer: PACE Senior Care Partners |
$101.31
|
| Rate for Payer: PACE SWMI |
$106.64
|
| Rate for Payer: PHP Commercial |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$106.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$371.10
|
| Rate for Payer: Priority Health Medicare |
$107.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$296.88
|
| Rate for Payer: Railroad Medicare Medicare |
$106.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.36
|
| Rate for Payer: UHC Core |
$356.17
|
| Rate for Payer: UHC Exchange |
$106.64
|
| Rate for Payer: UHC Medicaid |
$75.20
|
| Rate for Payer: UHC Medicare Advantage |
$106.64
|
| Rate for Payer: UHCCP Medicaid |
$75.20
|
| Rate for Payer: VA VA |
$106.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.91
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
IP
|
$366.70
|
|
|
Service Code
|
NDC 00904689961
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$255.22 |
| Max. Negotiated Rate |
$330.03 |
| Rate for Payer: Aetna Commercial |
$311.69
|
| Rate for Payer: BCBS Trust/PPO |
$302.86
|
| Rate for Payer: BCN Commercial |
$302.86
|
| Rate for Payer: Cash Price |
$293.36
|
| Rate for Payer: Cofinity Commercial |
$315.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.36
|
| Rate for Payer: Healthscope Commercial |
$330.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.69
|
| Rate for Payer: Nomi Health Commercial |
$300.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.02
|
| Rate for Payer: PHP Commercial |
$311.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$319.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.70
|
| Rate for Payer: UHC Core |
$306.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.02
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
OP
|
$366.70
|
|
|
Service Code
|
NDC 00904689961
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.65 |
| Max. Negotiated Rate |
$330.03 |
| Rate for Payer: Aetna Commercial |
$311.69
|
| Rate for Payer: Aetna Medicare |
$95.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.59
|
| Rate for Payer: BCBS Complete |
$67.88
|
| Rate for Payer: BCBS MAPPO |
$91.67
|
| Rate for Payer: BCBS Trust/PPO |
$301.46
|
| Rate for Payer: BCN Commercial |
$301.46
|
| Rate for Payer: BCN Medicare Advantage |
$91.67
|
| Rate for Payer: Cash Price |
$293.36
|
| Rate for Payer: Cofinity Commercial |
$315.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.67
|
| Rate for Payer: Healthscope Commercial |
$330.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.02
|
| Rate for Payer: Mclaren Medicaid |
$64.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.26
|
| Rate for Payer: Meridian Medicaid |
$67.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.69
|
| Rate for Payer: Nomi Health Commercial |
$300.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.02
|
| Rate for Payer: PACE Senior Care Partners |
$87.09
|
| Rate for Payer: PACE SWMI |
$91.67
|
| Rate for Payer: PHP Commercial |
$311.69
|
| Rate for Payer: PHP Medicare Advantage |
$91.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$319.03
|
| Rate for Payer: Priority Health Medicare |
$92.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.22
|
| Rate for Payer: Railroad Medicare Medicare |
$91.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.70
|
| Rate for Payer: UHC Core |
$306.19
|
| Rate for Payer: UHC Exchange |
$91.67
|
| Rate for Payer: UHC Medicaid |
$64.65
|
| Rate for Payer: UHC Medicare Advantage |
$91.67
|
| Rate for Payer: UHCCP Medicaid |
$64.65
|
| Rate for Payer: VA VA |
$91.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.02
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
OP
|
$124.55
|
|
|
Service Code
|
NDC 00093100301
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.96 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.87
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.92
|
| Rate for Payer: BCBS Complete |
$23.05
|
| Rate for Payer: BCBS MAPPO |
$31.14
|
| Rate for Payer: BCBS Trust/PPO |
$102.39
|
| Rate for Payer: BCN Commercial |
$102.39
|
| Rate for Payer: BCN Medicare Advantage |
$31.14
|
| Rate for Payer: Cash Price |
$99.64
|
| Rate for Payer: Cofinity Commercial |
$107.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.41
|
| Rate for Payer: Mclaren Medicaid |
$21.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.69
|
| Rate for Payer: Meridian Medicaid |
$23.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.87
|
| Rate for Payer: Nomi Health Commercial |
$102.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.41
|
| Rate for Payer: PACE Senior Care Partners |
$29.58
|
| Rate for Payer: PACE SWMI |
$31.14
|
| Rate for Payer: PHP Commercial |
$105.87
|
| Rate for Payer: PHP Medicare Advantage |
$31.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.36
|
| Rate for Payer: Priority Health Medicare |
$31.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.69
|
| Rate for Payer: Railroad Medicare Medicare |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$104.00
|
| Rate for Payer: UHC Exchange |
$31.14
|
| Rate for Payer: UHC Medicaid |
$21.96
|
| Rate for Payer: UHC Medicare Advantage |
$31.14
|
| Rate for Payer: UHCCP Medicaid |
$21.96
|
| Rate for Payer: VA VA |
$31.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.41
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
IP
|
$426.55
|
|
|
Service Code
|
NDC 51079096020
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$296.88 |
| Max. Negotiated Rate |
$383.89 |
| Rate for Payer: Aetna Commercial |
$362.57
|
| Rate for Payer: BCBS Trust/PPO |
$352.29
|
| Rate for Payer: BCN Commercial |
$352.29
|
| Rate for Payer: Cash Price |
$341.24
|
| Rate for Payer: Cofinity Commercial |
$366.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.24
|
| Rate for Payer: Healthscope Commercial |
$383.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.57
|
| Rate for Payer: Nomi Health Commercial |
$349.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.91
|
| Rate for Payer: PHP Commercial |
$362.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$371.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$296.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.36
|
| Rate for Payer: UHC Core |
$356.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.91
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
IP
|
$124.55
|
|
|
Service Code
|
NDC 00093100301
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.87
|
| Rate for Payer: BCBS Trust/PPO |
$102.87
|
| Rate for Payer: BCN Commercial |
$102.87
|
| Rate for Payer: Cash Price |
$99.64
|
| Rate for Payer: Cofinity Commercial |
$107.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.64
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.87
|
| Rate for Payer: Nomi Health Commercial |
$102.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.41
|
| Rate for Payer: PHP Commercial |
$105.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$104.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.41
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$249.10
|
|
|
Service Code
|
NDC 51079098520
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.37 |
| Max. Negotiated Rate |
$224.19 |
| Rate for Payer: Aetna Commercial |
$211.74
|
| Rate for Payer: BCBS Trust/PPO |
$205.73
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: Cash Price |
$199.28
|
| Rate for Payer: Cofinity Commercial |
$214.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.28
|
| Rate for Payer: Healthscope Commercial |
$224.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.74
|
| Rate for Payer: Nomi Health Commercial |
$204.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.82
|
| Rate for Payer: PHP Commercial |
$211.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$216.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.21
|
| Rate for Payer: UHC Core |
$208.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.82
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$225.60
|
|
|
Service Code
|
NDC 00904712261
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.02 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: BCBS Trust/PPO |
$186.32
|
| Rate for Payer: BCN Commercial |
$186.32
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.20
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
NDC 23155002301
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Aetna Commercial |
$79.90
|
| Rate for Payer: Aetna Medicare |
$24.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.38
|
| Rate for Payer: BCBS Complete |
$17.40
|
| Rate for Payer: BCBS MAPPO |
$23.50
|
| Rate for Payer: BCBS Trust/PPO |
$77.28
|
| Rate for Payer: BCN Commercial |
$77.28
|
| Rate for Payer: BCN Medicare Advantage |
$23.50
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$80.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.50
|
| Rate for Payer: Healthscope Commercial |
$84.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.50
|
| Rate for Payer: Mclaren Medicaid |
$16.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.68
|
| Rate for Payer: Meridian Medicaid |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.90
|
| Rate for Payer: Nomi Health Commercial |
$77.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: PACE Senior Care Partners |
$22.32
|
| Rate for Payer: PACE SWMI |
$23.50
|
| Rate for Payer: PHP Commercial |
$79.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.78
|
| Rate for Payer: Priority Health Medicare |
$23.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.42
|
| Rate for Payer: Railroad Medicare Medicare |
$23.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.72
|
| Rate for Payer: UHC Core |
$78.49
|
| Rate for Payer: UHC Exchange |
$23.50
|
| Rate for Payer: UHC Medicaid |
$16.57
|
| Rate for Payer: UHC Medicare Advantage |
$23.50
|
| Rate for Payer: UHCCP Medicaid |
$16.57
|
| Rate for Payer: VA VA |
$23.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.50
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$2.50
|
|
|
Service Code
|
NDC 51079098501
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Aetna Commercial |
$2.12
|
| Rate for Payer: Aetna Medicare |
$0.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.78
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.63
|
| Rate for Payer: BCBS Trust/PPO |
$2.06
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: BCN Medicare Advantage |
$0.63
|
| Rate for Payer: Cash Price |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$2.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.63
|
| Rate for Payer: Healthscope Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.88
|
| Rate for Payer: Mclaren Medicaid |
$0.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.66
|
| Rate for Payer: Meridian Medicaid |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Nomi Health Commercial |
$2.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.88
|
| Rate for Payer: PACE Senior Care Partners |
$0.59
|
| Rate for Payer: PACE SWMI |
$0.63
|
| Rate for Payer: PHP Commercial |
$2.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.17
|
| Rate for Payer: Priority Health Medicare |
$0.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.20
|
| Rate for Payer: UHC Core |
$2.09
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Medicaid |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.63
|
| Rate for Payer: UHCCP Medicaid |
$0.44
|
| Rate for Payer: VA VA |
$0.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.88
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$225.60
|
|
|
Service Code
|
NDC 00904712261
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.77 |
| Max. Negotiated Rate |
$203.04 |
| Rate for Payer: Aetna Commercial |
$191.76
|
| Rate for Payer: Aetna Medicare |
$58.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.50
|
| Rate for Payer: BCBS Complete |
$41.76
|
| Rate for Payer: BCBS MAPPO |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$185.47
|
| Rate for Payer: BCN Commercial |
$185.47
|
| Rate for Payer: BCN Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$180.48
|
| Rate for Payer: Cofinity Commercial |
$194.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$203.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.20
|
| Rate for Payer: Mclaren Medicaid |
$39.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.22
|
| Rate for Payer: Meridian Medicaid |
$41.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.76
|
| Rate for Payer: Nomi Health Commercial |
$184.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.20
|
| Rate for Payer: PACE Senior Care Partners |
$53.58
|
| Rate for Payer: PACE SWMI |
$56.40
|
| Rate for Payer: PHP Commercial |
$191.76
|
| Rate for Payer: PHP Medicare Advantage |
$56.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.27
|
| Rate for Payer: Priority Health Medicare |
$56.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.02
|
| Rate for Payer: Railroad Medicare Medicare |
$56.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.53
|
| Rate for Payer: UHC Core |
$188.38
|
| Rate for Payer: UHC Exchange |
$56.40
|
| Rate for Payer: UHC Medicaid |
$39.77
|
| Rate for Payer: UHC Medicare Advantage |
$56.40
|
| Rate for Payer: UHCCP Medicaid |
$39.77
|
| Rate for Payer: VA VA |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.20
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$2.50
|
|
|
Service Code
|
NDC 51079098501
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Aetna Commercial |
$2.12
|
| Rate for Payer: BCBS Trust/PPO |
$2.06
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: Cash Price |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$2.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.00
|
| Rate for Payer: Healthscope Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Nomi Health Commercial |
$2.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.88
|
| Rate for Payer: PHP Commercial |
$2.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.20
|
| Rate for Payer: UHC Core |
$2.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.88
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 68382018001
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.34
|
| Rate for Payer: BCN Commercial |
$87.34
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Nomi Health Commercial |
$86.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.06
|
| Rate for Payer: UHC Core |
$88.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 68382018001
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.05
|
| Rate for Payer: BCBS Complete |
$19.57
|
| Rate for Payer: BCBS MAPPO |
$26.44
|
| Rate for Payer: BCBS Trust/PPO |
$86.94
|
| Rate for Payer: BCN Commercial |
$86.94
|
| Rate for Payer: BCN Medicare Advantage |
$26.44
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.44
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.76
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Nomi Health Commercial |
$86.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PACE Senior Care Partners |
$25.12
|
| Rate for Payer: PACE SWMI |
$26.44
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: PHP Medicare Advantage |
$26.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.00
|
| Rate for Payer: Priority Health Medicare |
$26.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.60
|
| Rate for Payer: Railroad Medicare Medicare |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.06
|
| Rate for Payer: UHC Core |
$88.30
|
| Rate for Payer: UHC Exchange |
$26.44
|
| Rate for Payer: UHC Medicaid |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$26.44
|
| Rate for Payer: UHCCP Medicaid |
$18.64
|
| Rate for Payer: VA VA |
$26.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$65.80
|
|
|
Service Code
|
NDC 16729020001
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$59.22 |
| Rate for Payer: Aetna Commercial |
$55.93
|
| Rate for Payer: BCBS Trust/PPO |
$54.34
|
| Rate for Payer: BCN Commercial |
$54.34
|
| Rate for Payer: Cash Price |
$52.64
|
| Rate for Payer: Cofinity Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.64
|
| Rate for Payer: Healthscope Commercial |
$59.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.93
|
| Rate for Payer: Nomi Health Commercial |
$53.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.35
|
| Rate for Payer: PHP Commercial |
$55.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.90
|
| Rate for Payer: UHC Core |
$54.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.35
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$249.10
|
|
|
Service Code
|
NDC 51079098520
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.92 |
| Max. Negotiated Rate |
$224.19 |
| Rate for Payer: Aetna Commercial |
$211.74
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.84
|
| Rate for Payer: BCBS Complete |
$46.11
|
| Rate for Payer: BCBS MAPPO |
$62.27
|
| Rate for Payer: BCBS Trust/PPO |
$204.79
|
| Rate for Payer: BCN Commercial |
$204.79
|
| Rate for Payer: BCN Medicare Advantage |
$62.27
|
| Rate for Payer: Cash Price |
$199.28
|
| Rate for Payer: Cofinity Commercial |
$214.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.27
|
| Rate for Payer: Healthscope Commercial |
$224.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.82
|
| Rate for Payer: Mclaren Medicaid |
$43.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$46.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.74
|
| Rate for Payer: Nomi Health Commercial |
$204.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.82
|
| Rate for Payer: PACE Senior Care Partners |
$59.16
|
| Rate for Payer: PACE SWMI |
$62.27
|
| Rate for Payer: PHP Commercial |
$211.74
|
| Rate for Payer: PHP Medicare Advantage |
$62.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$216.72
|
| Rate for Payer: Priority Health Medicare |
$62.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.37
|
| Rate for Payer: Railroad Medicare Medicare |
$62.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.21
|
| Rate for Payer: UHC Core |
$208.00
|
| Rate for Payer: UHC Exchange |
$62.27
|
| Rate for Payer: UHC Medicaid |
$43.92
|
| Rate for Payer: UHC Medicare Advantage |
$62.27
|
| Rate for Payer: UHCCP Medicaid |
$43.92
|
| Rate for Payer: VA VA |
$62.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.82
|
|
