|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.59
|
|
|
Service Code
|
NDC 00703115303
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.31
|
| Rate for Payer: BCBS Complete |
$13.81
|
| Rate for Payer: BCBS MAPPO |
$18.65
|
| Rate for Payer: BCBS Trust/PPO |
$61.32
|
| Rate for Payer: BCN Commercial |
$61.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.65
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.65
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Mclaren Medicaid |
$13.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.58
|
| Rate for Payer: Meridian Medicaid |
$13.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: PACE Senior Care Partners |
$17.72
|
| Rate for Payer: PACE SWMI |
$18.65
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: PHP Medicare Advantage |
$18.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.89
|
| Rate for Payer: Priority Health Medicare |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.64
|
| Rate for Payer: UHC Core |
$62.28
|
| Rate for Payer: UHC Exchange |
$18.65
|
| Rate for Payer: UHC Medicaid |
$13.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.65
|
| Rate for Payer: UHCCP Medicaid |
$13.15
|
| Rate for Payer: VA VA |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.59
|
|
|
Service Code
|
NDC 00703115301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.31
|
| Rate for Payer: BCBS Complete |
$13.81
|
| Rate for Payer: BCBS MAPPO |
$18.65
|
| Rate for Payer: BCBS Trust/PPO |
$61.32
|
| Rate for Payer: BCN Commercial |
$61.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.65
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.65
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Mclaren Medicaid |
$13.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.58
|
| Rate for Payer: Meridian Medicaid |
$13.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: PACE Senior Care Partners |
$17.72
|
| Rate for Payer: PACE SWMI |
$18.65
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: PHP Medicare Advantage |
$18.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.89
|
| Rate for Payer: Priority Health Medicare |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.64
|
| Rate for Payer: UHC Core |
$62.28
|
| Rate for Payer: UHC Exchange |
$18.65
|
| Rate for Payer: UHC Medicaid |
$13.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.65
|
| Rate for Payer: UHCCP Medicaid |
$13.15
|
| Rate for Payer: VA VA |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.92
|
|
|
Service Code
|
NDC 67457085200
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: Aetna Medicare |
$3.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.66
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS MAPPO |
$3.73
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: BCN Medicare Advantage |
$3.73
|
| Rate for Payer: Cash Price |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$12.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.73
|
| Rate for Payer: Healthscope Commercial |
$13.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.19
|
| Rate for Payer: Mclaren Medicaid |
$2.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.92
|
| Rate for Payer: Meridian Medicaid |
$2.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.68
|
| Rate for Payer: Nomi Health Commercial |
$12.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.19
|
| Rate for Payer: PACE Senior Care Partners |
$3.54
|
| Rate for Payer: PACE SWMI |
$3.73
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicare Advantage |
$3.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.98
|
| Rate for Payer: Priority Health Medicare |
$3.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.13
|
| Rate for Payer: UHC Core |
$12.46
|
| Rate for Payer: UHC Exchange |
$3.73
|
| Rate for Payer: UHC Medicaid |
$2.63
|
| Rate for Payer: UHC Medicare Advantage |
$3.73
|
| Rate for Payer: UHCCP Medicaid |
$2.63
|
| Rate for Payer: VA VA |
$3.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
NDC 00143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: BCBS Trust/PPO |
$22.27
|
| Rate for Payer: BCN Commercial |
$22.27
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
NDC 00143931801
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: BCBS Trust/PPO |
$22.27
|
| Rate for Payer: BCN Commercial |
$22.27
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.26
|
|
|
Service Code
|
NDC 51991098399
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$13.43
|
| Rate for Payer: BCN Commercial |
$13.43
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.20
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.59
|
|
|
Service Code
|
NDC 00703115303
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$51.91 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: BCBS Trust/PPO |
$61.60
|
| Rate for Payer: BCN Commercial |
$61.60
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.64
|
| Rate for Payer: UHC Core |
$62.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.71
|
|
|
Service Code
|
NDC 43066099710
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$18.64 |
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna Medicare |
$5.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$3.83
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$17.03
|
| Rate for Payer: BCN Commercial |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cofinity Commercial |
$17.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$18.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$3.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PACE Senior Care Partners |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.02
|
| Rate for Payer: Priority Health Medicare |
$5.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC Core |
$17.29
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicaid |
$3.65
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.62
|
|
|
Service Code
|
NDC 00409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Medicare |
$4.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.82
|
| Rate for Payer: BCBS Complete |
$3.45
|
| Rate for Payer: BCBS MAPPO |
$4.66
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Medicare Advantage |
$4.66
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.66
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Mclaren Medicaid |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.89
|
| Rate for Payer: Meridian Medicaid |
$3.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: PACE Senior Care Partners |
$4.42
|
| Rate for Payer: PACE SWMI |
$4.66
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicare Advantage |
$4.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.20
|
| Rate for Payer: Priority Health Medicare |
$4.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.39
|
| Rate for Payer: UHC Core |
$15.55
|
| Rate for Payer: UHC Exchange |
$4.66
|
| Rate for Payer: UHC Medicaid |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$4.66
|
| Rate for Payer: UHCCP Medicaid |
$3.28
|
| Rate for Payer: VA VA |
$4.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
NDC 00143931801
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.43
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS MAPPO |
$6.74
|
| Rate for Payer: BCBS Trust/PPO |
$22.17
|
| Rate for Payer: BCN Commercial |
$22.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.74
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.74
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.08
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE SWMI |
$6.74
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Medicare |
$6.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: Railroad Medicare Medicare |
$6.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: UHC Exchange |
$6.74
|
| Rate for Payer: UHC Medicaid |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$4.75
|
| Rate for Payer: VA VA |
$6.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.92
|
|
|
Service Code
|
NDC 67457085204
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.32
|
| Rate for Payer: BCN Commercial |
$12.32
|
| Rate for Payer: Cash Price |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$12.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$13.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.68
|
| Rate for Payer: Nomi Health Commercial |
$12.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.19
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.13
|
| Rate for Payer: UHC Core |
$12.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.26
|
|
|
Service Code
|
NDC 51991098317
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.08
|
| Rate for Payer: BCBS Complete |
$3.01
|
| Rate for Payer: BCBS MAPPO |
$4.07
|
| Rate for Payer: BCBS Trust/PPO |
$13.37
|
| Rate for Payer: BCN Commercial |
$13.37
|
| Rate for Payer: BCN Medicare Advantage |
$4.07
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.07
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Mclaren Medicaid |
$2.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$3.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.20
|
| Rate for Payer: PACE Senior Care Partners |
$3.86
|
| Rate for Payer: PACE SWMI |
$4.07
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: PHP Medicare Advantage |
$4.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Medicare |
$4.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: UHC Exchange |
$4.07
|
| Rate for Payer: UHC Medicaid |
$2.87
|
| Rate for Payer: UHC Medicare Advantage |
$4.07
|
| Rate for Payer: UHCCP Medicaid |
$2.87
|
| Rate for Payer: VA VA |
$4.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.62
|
|
|
Service Code
|
NDC 00409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: BCBS Trust/PPO |
$15.38
|
| Rate for Payer: BCN Commercial |
$15.38
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.39
|
| Rate for Payer: UHC Core |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.71
|
|
|
Service Code
|
NDC 43066099701
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$18.64 |
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$17.10
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cofinity Commercial |
$17.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.57
|
| Rate for Payer: Healthscope Commercial |
$18.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC Core |
$17.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.26
|
|
|
Service Code
|
NDC 51991098317
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$13.43
|
| Rate for Payer: BCN Commercial |
$13.43
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.20
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
NDC 00143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.43
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS MAPPO |
$6.74
|
| Rate for Payer: BCBS Trust/PPO |
$22.17
|
| Rate for Payer: BCN Commercial |
$22.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.74
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.74
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.08
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE SWMI |
$6.74
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Medicare |
$6.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: Railroad Medicare Medicare |
$6.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: UHC Exchange |
$6.74
|
| Rate for Payer: UHC Medicaid |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$4.75
|
| Rate for Payer: VA VA |
$6.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.71
|
|
|
Service Code
|
NDC 43066099710
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$18.64 |
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$17.10
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cofinity Commercial |
$17.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.57
|
| Rate for Payer: Healthscope Commercial |
$18.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC Core |
$17.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.59
|
|
|
Service Code
|
NDC 00703115301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$51.91 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: BCBS Trust/PPO |
$61.60
|
| Rate for Payer: BCN Commercial |
$61.60
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.64
|
| Rate for Payer: UHC Core |
$62.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.71
|
|
|
Service Code
|
NDC 43066099701
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$18.64 |
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna Medicare |
$5.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$3.83
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$17.03
|
| Rate for Payer: BCN Commercial |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cofinity Commercial |
$17.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$18.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$3.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PACE Senior Care Partners |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.02
|
| Rate for Payer: Priority Health Medicare |
$5.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC Core |
$17.29
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicaid |
$3.65
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.92
|
|
|
Service Code
|
NDC 67457085204
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: Aetna Medicare |
$3.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.66
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS MAPPO |
$3.73
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: BCN Medicare Advantage |
$3.73
|
| Rate for Payer: Cash Price |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$12.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.73
|
| Rate for Payer: Healthscope Commercial |
$13.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.19
|
| Rate for Payer: Mclaren Medicaid |
$2.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.92
|
| Rate for Payer: Meridian Medicaid |
$2.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.68
|
| Rate for Payer: Nomi Health Commercial |
$12.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.19
|
| Rate for Payer: PACE Senior Care Partners |
$3.54
|
| Rate for Payer: PACE SWMI |
$3.73
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicare Advantage |
$3.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.98
|
| Rate for Payer: Priority Health Medicare |
$3.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.13
|
| Rate for Payer: UHC Core |
$12.46
|
| Rate for Payer: UHC Exchange |
$3.73
|
| Rate for Payer: UHC Medicaid |
$2.63
|
| Rate for Payer: UHC Medicare Advantage |
$3.73
|
| Rate for Payer: UHCCP Medicaid |
$2.63
|
| Rate for Payer: VA VA |
$3.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.92
|
|
|
Service Code
|
NDC 67457085200
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$13.43 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.32
|
| Rate for Payer: BCN Commercial |
$12.32
|
| Rate for Payer: Cash Price |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$12.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$13.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.68
|
| Rate for Payer: Nomi Health Commercial |
$12.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.19
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.13
|
| Rate for Payer: UHC Core |
$12.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.26
|
|
|
Service Code
|
NDC 51991098399
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.08
|
| Rate for Payer: BCBS Complete |
$3.01
|
| Rate for Payer: BCBS MAPPO |
$4.07
|
| Rate for Payer: BCBS Trust/PPO |
$13.37
|
| Rate for Payer: BCN Commercial |
$13.37
|
| Rate for Payer: BCN Medicare Advantage |
$4.07
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.07
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Mclaren Medicaid |
$2.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$3.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.20
|
| Rate for Payer: PACE Senior Care Partners |
$3.86
|
| Rate for Payer: PACE SWMI |
$4.07
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: PHP Medicare Advantage |
$4.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Medicare |
$4.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: UHC Exchange |
$4.07
|
| Rate for Payer: UHC Medicaid |
$2.87
|
| Rate for Payer: UHC Medicare Advantage |
$4.07
|
| Rate for Payer: UHCCP Medicaid |
$2.87
|
| Rate for Payer: VA VA |
$4.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION
|
Facility
|
IP
|
$21.50
|
|
|
Service Code
|
NDC 44567064101
|
| Hospital Charge Code |
119763
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.96 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: BCBS Trust/PPO |
$17.76
|
| Rate for Payer: BCN Commercial |
$17.76
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Nomi Health Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.92
|
| Rate for Payer: UHC Core |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
NDC 44567064101
|
| Hospital Charge Code |
119763
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.79 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare |
$5.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.72
|
| Rate for Payer: BCBS Complete |
$3.98
|
| Rate for Payer: BCBS MAPPO |
$5.38
|
| Rate for Payer: BCBS Trust/PPO |
$17.68
|
| Rate for Payer: BCN Commercial |
$17.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.38
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.38
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Mclaren Medicaid |
$3.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.64
|
| Rate for Payer: Meridian Medicaid |
$3.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Nomi Health Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PACE Senior Care Partners |
$5.11
|
| Rate for Payer: PACE SWMI |
$5.38
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Medicare Advantage |
$5.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.70
|
| Rate for Payer: Priority Health Medicare |
$5.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.92
|
| Rate for Payer: UHC Core |
$17.95
|
| Rate for Payer: UHC Exchange |
$5.38
|
| Rate for Payer: UHC Medicaid |
$3.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UHCCP Medicaid |
$3.79
|
| Rate for Payer: VA VA |
$5.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
NDC 44567064110
|
| Hospital Charge Code |
119763
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.79 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare |
$5.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.72
|
| Rate for Payer: BCBS Complete |
$3.98
|
| Rate for Payer: BCBS MAPPO |
$5.38
|
| Rate for Payer: BCBS Trust/PPO |
$17.68
|
| Rate for Payer: BCN Commercial |
$17.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.38
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.38
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Mclaren Medicaid |
$3.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.64
|
| Rate for Payer: Meridian Medicaid |
$3.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Nomi Health Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PACE Senior Care Partners |
$5.11
|
| Rate for Payer: PACE SWMI |
$5.38
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Medicare Advantage |
$5.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.70
|
| Rate for Payer: Priority Health Medicare |
$5.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.92
|
| Rate for Payer: UHC Core |
$17.95
|
| Rate for Payer: UHC Exchange |
$5.38
|
| Rate for Payer: UHC Medicaid |
$3.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UHCCP Medicaid |
$3.79
|
| Rate for Payer: VA VA |
$5.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
