|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$4.66
|
|
|
Service Code
|
NDC 68462015740
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Aetna Commercial |
$3.96
|
| Rate for Payer: Aetna Medicare |
$1.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.46
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS MAPPO |
$1.17
|
| Rate for Payer: BCBS Trust/PPO |
$3.83
|
| Rate for Payer: BCN Commercial |
$3.83
|
| Rate for Payer: BCN Medicare Advantage |
$1.17
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Cofinity Commercial |
$4.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.17
|
| Rate for Payer: Healthscope Commercial |
$4.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.50
|
| Rate for Payer: Mclaren Medicaid |
$0.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.22
|
| Rate for Payer: Meridian Medicaid |
$0.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.96
|
| Rate for Payer: Nomi Health Commercial |
$3.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.50
|
| Rate for Payer: PACE Senior Care Partners |
$1.11
|
| Rate for Payer: PACE SWMI |
$1.17
|
| Rate for Payer: PHP Commercial |
$3.96
|
| Rate for Payer: PHP Medicare Advantage |
$1.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.05
|
| Rate for Payer: Priority Health Medicare |
$1.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.10
|
| Rate for Payer: UHC Core |
$3.89
|
| Rate for Payer: UHC Exchange |
$1.17
|
| Rate for Payer: UHC Medicaid |
$0.82
|
| Rate for Payer: UHC Medicare Advantage |
$1.17
|
| Rate for Payer: UHCCP Medicaid |
$0.82
|
| Rate for Payer: VA VA |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.50
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$44.55
|
|
|
Service Code
|
NDC 50268064711
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$40.09 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: Aetna Medicare |
$11.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.92
|
| Rate for Payer: BCBS Complete |
$8.25
|
| Rate for Payer: BCBS MAPPO |
$11.14
|
| Rate for Payer: BCBS Trust/PPO |
$36.62
|
| Rate for Payer: BCN Commercial |
$36.62
|
| Rate for Payer: BCN Medicare Advantage |
$11.14
|
| Rate for Payer: Cash Price |
$35.64
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.14
|
| Rate for Payer: Healthscope Commercial |
$40.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.41
|
| Rate for Payer: Mclaren Medicaid |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.69
|
| Rate for Payer: Meridian Medicaid |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$36.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.41
|
| Rate for Payer: PACE Senior Care Partners |
$10.58
|
| Rate for Payer: PACE SWMI |
$11.14
|
| Rate for Payer: PHP Commercial |
$37.87
|
| Rate for Payer: PHP Medicare Advantage |
$11.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.76
|
| Rate for Payer: Priority Health Medicare |
$11.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.20
|
| Rate for Payer: UHC Core |
$37.20
|
| Rate for Payer: UHC Exchange |
$11.14
|
| Rate for Payer: UHC Medicaid |
$7.85
|
| Rate for Payer: UHC Medicare Advantage |
$11.14
|
| Rate for Payer: UHCCP Medicaid |
$7.85
|
| Rate for Payer: VA VA |
$11.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.41
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$44.55
|
|
|
Service Code
|
NDC 50268064711
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.01 |
| Max. Negotiated Rate |
$40.09 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: BCBS Trust/PPO |
$36.79
|
| Rate for Payer: BCN Commercial |
$36.79
|
| Rate for Payer: Cash Price |
$35.64
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.64
|
| Rate for Payer: Healthscope Commercial |
$40.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$36.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.41
|
| Rate for Payer: PHP Commercial |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.20
|
| Rate for Payer: UHC Core |
$37.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.41
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$47.81
|
|
|
Service Code
|
NDC 00904707393
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$43.03 |
| Rate for Payer: Aetna Commercial |
$40.64
|
| Rate for Payer: BCBS Trust/PPO |
$39.49
|
| Rate for Payer: BCN Commercial |
$39.49
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.25
|
| Rate for Payer: Healthscope Commercial |
$43.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.64
|
| Rate for Payer: Nomi Health Commercial |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.86
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.07
|
| Rate for Payer: UHC Core |
$39.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.86
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$41.70
|
|
|
Service Code
|
NDC 60687025240
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.02 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: BCBS Trust/PPO |
$34.44
|
| Rate for Payer: BCN Commercial |
$34.44
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$41.70
|
|
|
Service Code
|
NDC 60687025246
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.02 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: BCBS Trust/PPO |
$34.44
|
| Rate for Payer: BCN Commercial |
$34.44
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$47.81
|
|
|
Service Code
|
NDC 00904707393
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$43.03 |
| Rate for Payer: Aetna Commercial |
$40.64
|
| Rate for Payer: Aetna Medicare |
$12.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.94
|
| Rate for Payer: BCBS Complete |
$8.85
|
| Rate for Payer: BCBS MAPPO |
$11.95
|
| Rate for Payer: BCBS Trust/PPO |
$39.30
|
| Rate for Payer: BCN Commercial |
$39.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.95
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.95
|
| Rate for Payer: Healthscope Commercial |
$43.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.86
|
| Rate for Payer: Mclaren Medicaid |
$8.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.55
|
| Rate for Payer: Meridian Medicaid |
$8.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.64
|
| Rate for Payer: Nomi Health Commercial |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.86
|
| Rate for Payer: PACE Senior Care Partners |
$11.35
|
| Rate for Payer: PACE SWMI |
$11.95
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: PHP Medicare Advantage |
$11.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.59
|
| Rate for Payer: Priority Health Medicare |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.07
|
| Rate for Payer: UHC Core |
$39.92
|
| Rate for Payer: UHC Exchange |
$11.95
|
| Rate for Payer: UHC Medicaid |
$8.43
|
| Rate for Payer: UHC Medicare Advantage |
$11.95
|
| Rate for Payer: UHCCP Medicaid |
$8.43
|
| Rate for Payer: VA VA |
$11.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.86
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$116.38
|
|
|
Service Code
|
NDC 65162069179
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$104.74 |
| Rate for Payer: Aetna Commercial |
$98.92
|
| Rate for Payer: Aetna Medicare |
$30.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.37
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$29.09
|
| Rate for Payer: BCBS Trust/PPO |
$95.68
|
| Rate for Payer: BCN Commercial |
$95.68
|
| Rate for Payer: BCN Medicare Advantage |
$29.09
|
| Rate for Payer: Cash Price |
$93.10
|
| Rate for Payer: Cofinity Commercial |
$100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.09
|
| Rate for Payer: Healthscope Commercial |
$104.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.28
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.55
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.92
|
| Rate for Payer: Nomi Health Commercial |
$95.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.28
|
| Rate for Payer: PACE Senior Care Partners |
$27.64
|
| Rate for Payer: PACE SWMI |
$29.09
|
| Rate for Payer: PHP Commercial |
$98.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.25
|
| Rate for Payer: Priority Health Medicare |
$29.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.00
|
| Rate for Payer: Railroad Medicare Medicare |
$29.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.41
|
| Rate for Payer: UHC Core |
$97.18
|
| Rate for Payer: UHC Exchange |
$29.09
|
| Rate for Payer: UHC Medicaid |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$29.09
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: VA VA |
$29.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.28
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$47.81
|
|
|
Service Code
|
NDC 00904707341
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$43.03 |
| Rate for Payer: Aetna Commercial |
$40.64
|
| Rate for Payer: BCBS Trust/PPO |
$39.49
|
| Rate for Payer: BCN Commercial |
$39.49
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.25
|
| Rate for Payer: Healthscope Commercial |
$43.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.64
|
| Rate for Payer: Nomi Health Commercial |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.86
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.07
|
| Rate for Payer: UHC Core |
$39.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.86
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$41.70
|
|
|
Service Code
|
NDC 60687025286
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.02 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: BCBS Trust/PPO |
$34.44
|
| Rate for Payer: BCN Commercial |
$34.44
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$116.38
|
|
|
Service Code
|
NDC 65162069179
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$104.74 |
| Rate for Payer: Aetna Commercial |
$98.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.12
|
| Rate for Payer: BCN Commercial |
$96.12
|
| Rate for Payer: Cash Price |
$93.10
|
| Rate for Payer: Cofinity Commercial |
$100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.10
|
| Rate for Payer: Healthscope Commercial |
$104.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.92
|
| Rate for Payer: Nomi Health Commercial |
$95.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.28
|
| Rate for Payer: PHP Commercial |
$98.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.41
|
| Rate for Payer: UHC Core |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.28
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$53.36
|
|
|
Service Code
|
NDC 68094076359
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.41 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: Aetna Medicare |
$13.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.68
|
| Rate for Payer: BCBS Complete |
$9.88
|
| Rate for Payer: BCBS MAPPO |
$13.34
|
| Rate for Payer: BCBS Trust/PPO |
$43.87
|
| Rate for Payer: BCN Commercial |
$43.87
|
| Rate for Payer: BCN Medicare Advantage |
$13.34
|
| Rate for Payer: Cash Price |
$42.69
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.34
|
| Rate for Payer: Healthscope Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.02
|
| Rate for Payer: Mclaren Medicaid |
$9.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.01
|
| Rate for Payer: Meridian Medicaid |
$9.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.36
|
| Rate for Payer: Nomi Health Commercial |
$43.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.67
|
| Rate for Payer: PACE SWMI |
$13.34
|
| Rate for Payer: PHP Commercial |
$45.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.42
|
| Rate for Payer: Priority Health Medicare |
$13.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.96
|
| Rate for Payer: UHC Core |
$44.56
|
| Rate for Payer: UHC Exchange |
$13.34
|
| Rate for Payer: UHC Medicaid |
$9.41
|
| Rate for Payer: UHC Medicare Advantage |
$13.34
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$13.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.02
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$53.36
|
|
|
Service Code
|
NDC 68094076362
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.14 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: BCBS Trust/PPO |
$44.07
|
| Rate for Payer: BCN Commercial |
$44.07
|
| Rate for Payer: Cash Price |
$42.69
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.69
|
| Rate for Payer: Healthscope Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.36
|
| Rate for Payer: Nomi Health Commercial |
$43.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.02
|
| Rate for Payer: PHP Commercial |
$45.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.96
|
| Rate for Payer: UHC Core |
$44.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.02
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$47.81
|
|
|
Service Code
|
NDC 00904707341
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$43.03 |
| Rate for Payer: Aetna Commercial |
$40.64
|
| Rate for Payer: Aetna Medicare |
$12.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.94
|
| Rate for Payer: BCBS Complete |
$8.85
|
| Rate for Payer: BCBS MAPPO |
$11.95
|
| Rate for Payer: BCBS Trust/PPO |
$39.30
|
| Rate for Payer: BCN Commercial |
$39.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.95
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.95
|
| Rate for Payer: Healthscope Commercial |
$43.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.86
|
| Rate for Payer: Mclaren Medicaid |
$8.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.55
|
| Rate for Payer: Meridian Medicaid |
$8.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.64
|
| Rate for Payer: Nomi Health Commercial |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.86
|
| Rate for Payer: PACE Senior Care Partners |
$11.35
|
| Rate for Payer: PACE SWMI |
$11.95
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: PHP Medicare Advantage |
$11.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.59
|
| Rate for Payer: Priority Health Medicare |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.07
|
| Rate for Payer: UHC Core |
$39.92
|
| Rate for Payer: UHC Exchange |
$11.95
|
| Rate for Payer: UHC Medicaid |
$8.43
|
| Rate for Payer: UHC Medicare Advantage |
$11.95
|
| Rate for Payer: UHCCP Medicaid |
$8.43
|
| Rate for Payer: VA VA |
$11.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.86
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$53.36
|
|
|
Service Code
|
NDC 68094076362
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.41 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: Aetna Medicare |
$13.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.68
|
| Rate for Payer: BCBS Complete |
$9.88
|
| Rate for Payer: BCBS MAPPO |
$13.34
|
| Rate for Payer: BCBS Trust/PPO |
$43.87
|
| Rate for Payer: BCN Commercial |
$43.87
|
| Rate for Payer: BCN Medicare Advantage |
$13.34
|
| Rate for Payer: Cash Price |
$42.69
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.34
|
| Rate for Payer: Healthscope Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.02
|
| Rate for Payer: Mclaren Medicaid |
$9.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.01
|
| Rate for Payer: Meridian Medicaid |
$9.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.36
|
| Rate for Payer: Nomi Health Commercial |
$43.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.67
|
| Rate for Payer: PACE SWMI |
$13.34
|
| Rate for Payer: PHP Commercial |
$45.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.42
|
| Rate for Payer: Priority Health Medicare |
$13.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.96
|
| Rate for Payer: UHC Core |
$44.56
|
| Rate for Payer: UHC Exchange |
$13.34
|
| Rate for Payer: UHC Medicaid |
$9.41
|
| Rate for Payer: UHC Medicare Advantage |
$13.34
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$13.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.02
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$41.70
|
|
|
Service Code
|
NDC 60687025246
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: Aetna Medicare |
$10.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.03
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$34.28
|
| Rate for Payer: BCN Commercial |
$34.28
|
| Rate for Payer: BCN Medicare Advantage |
$10.43
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.95
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PACE Senior Care Partners |
$9.90
|
| Rate for Payer: PACE SWMI |
$10.43
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: PHP Medicare Advantage |
$10.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Medicare |
$10.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: Railroad Medicare Medicare |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$7.35
|
| Rate for Payer: UHC Medicare Advantage |
$10.43
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: VA VA |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$44.55
|
|
|
Service Code
|
NDC 50268064714
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$40.09 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: Aetna Medicare |
$11.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.92
|
| Rate for Payer: BCBS Complete |
$8.25
|
| Rate for Payer: BCBS MAPPO |
$11.14
|
| Rate for Payer: BCBS Trust/PPO |
$36.62
|
| Rate for Payer: BCN Commercial |
$36.62
|
| Rate for Payer: BCN Medicare Advantage |
$11.14
|
| Rate for Payer: Cash Price |
$35.64
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.14
|
| Rate for Payer: Healthscope Commercial |
$40.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.41
|
| Rate for Payer: Mclaren Medicaid |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.69
|
| Rate for Payer: Meridian Medicaid |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$36.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.41
|
| Rate for Payer: PACE Senior Care Partners |
$10.58
|
| Rate for Payer: PACE SWMI |
$11.14
|
| Rate for Payer: PHP Commercial |
$37.87
|
| Rate for Payer: PHP Medicare Advantage |
$11.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.76
|
| Rate for Payer: Priority Health Medicare |
$11.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.20
|
| Rate for Payer: UHC Core |
$37.20
|
| Rate for Payer: UHC Exchange |
$11.14
|
| Rate for Payer: UHC Medicaid |
$7.85
|
| Rate for Payer: UHC Medicare Advantage |
$11.14
|
| Rate for Payer: UHCCP Medicaid |
$7.85
|
| Rate for Payer: VA VA |
$11.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.41
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$41.70
|
|
|
Service Code
|
NDC 60687025286
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: Aetna Medicare |
$10.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.03
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$34.28
|
| Rate for Payer: BCN Commercial |
$34.28
|
| Rate for Payer: BCN Medicare Advantage |
$10.43
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.95
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PACE Senior Care Partners |
$9.90
|
| Rate for Payer: PACE SWMI |
$10.43
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: PHP Medicare Advantage |
$10.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Medicare |
$10.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: Railroad Medicare Medicare |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$7.35
|
| Rate for Payer: UHC Medicare Advantage |
$10.43
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: VA VA |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$53.36
|
|
|
Service Code
|
NDC 68094076359
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.14 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Aetna Commercial |
$45.36
|
| Rate for Payer: BCBS Trust/PPO |
$44.07
|
| Rate for Payer: BCN Commercial |
$44.07
|
| Rate for Payer: Cash Price |
$42.69
|
| Rate for Payer: Cofinity Commercial |
$45.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.69
|
| Rate for Payer: Healthscope Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.36
|
| Rate for Payer: Nomi Health Commercial |
$43.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.02
|
| Rate for Payer: PHP Commercial |
$45.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.96
|
| Rate for Payer: UHC Core |
$44.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.02
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$41.70
|
|
|
Service Code
|
NDC 60687025240
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$37.53 |
| Rate for Payer: Aetna Commercial |
$35.45
|
| Rate for Payer: Aetna Medicare |
$10.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.03
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$34.28
|
| Rate for Payer: BCN Commercial |
$34.28
|
| Rate for Payer: BCN Medicare Advantage |
$10.43
|
| Rate for Payer: Cash Price |
$33.36
|
| Rate for Payer: Cofinity Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$37.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.27
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.95
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.27
|
| Rate for Payer: PACE Senior Care Partners |
$9.90
|
| Rate for Payer: PACE SWMI |
$10.43
|
| Rate for Payer: PHP Commercial |
$35.45
|
| Rate for Payer: PHP Medicare Advantage |
$10.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.28
|
| Rate for Payer: Priority Health Medicare |
$10.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.02
|
| Rate for Payer: Railroad Medicare Medicare |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.70
|
| Rate for Payer: UHC Core |
$34.82
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$7.35
|
| Rate for Payer: UHC Medicare Advantage |
$10.43
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: VA VA |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.27
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$14.30
|
|
|
Service Code
|
NDC 09900000346
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.47
|
| Rate for Payer: BCBS Complete |
$2.65
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.76
|
| Rate for Payer: BCN Commercial |
$11.76
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Mclaren Medicaid |
$2.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.75
|
| Rate for Payer: Meridian Medicaid |
$2.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Nomi Health Commercial |
$11.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: PACE Senior Care Partners |
$3.40
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.44
|
| Rate for Payer: Priority Health Medicare |
$3.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.58
|
| Rate for Payer: UHC Core |
$11.94
|
| Rate for Payer: UHC Exchange |
$3.58
|
| Rate for Payer: UHC Medicaid |
$2.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$3.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$14.30
|
|
|
Service Code
|
NDC 09900000346
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.95 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: BCBS Trust/PPO |
$11.81
|
| Rate for Payer: BCN Commercial |
$11.81
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Nomi Health Commercial |
$11.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.58
|
| Rate for Payer: UHC Core |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$44.55
|
|
|
Service Code
|
NDC 50268064714
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.01 |
| Max. Negotiated Rate |
$40.09 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: BCBS Trust/PPO |
$36.79
|
| Rate for Payer: BCN Commercial |
$36.79
|
| Rate for Payer: Cash Price |
$35.64
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.64
|
| Rate for Payer: Healthscope Commercial |
$40.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$36.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.41
|
| Rate for Payer: PHP Commercial |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.20
|
| Rate for Payer: UHC Core |
$37.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.41
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
IP
|
$13.95
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Commercial |
$8.70
|
| Rate for Payer: Aetna Commercial |
$4.76
|
| Rate for Payer: BCBS Trust/PPO |
$11.52
|
| Rate for Payer: BCBS Trust/PPO |
$4.63
|
| Rate for Payer: BCBS Trust/PPO |
$10.03
|
| Rate for Payer: BCBS Trust/PPO |
$8.46
|
| Rate for Payer: BCN Commercial |
$11.52
|
| Rate for Payer: BCN Commercial |
$8.46
|
| Rate for Payer: BCN Commercial |
$4.63
|
| Rate for Payer: BCN Commercial |
$10.03
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$4.48
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$4.82
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$5.04
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.76
|
| Rate for Payer: Nomi Health Commercial |
$8.40
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$4.59
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.20
|
| Rate for Payer: PHP Commercial |
$4.76
|
| Rate for Payer: PHP Commercial |
$8.70
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC Core |
$11.65
|
| Rate for Payer: UHC Core |
$4.68
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Core |
$8.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
OP
|
$10.24
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna Commercial |
$8.70
|
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Commercial |
$4.76
|
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Medicare |
$3.16
|
| Rate for Payer: Aetna Medicare |
$2.66
|
| Rate for Payer: Aetna Medicare |
$3.63
|
| Rate for Payer: Aetna Medicare |
$1.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.20
|
| Rate for Payer: BCBS Complete |
$1.04
|
| Rate for Payer: BCBS Complete |
$2.25
|
| Rate for Payer: BCBS Complete |
$1.90
|
| Rate for Payer: BCBS Complete |
$2.58
|
| Rate for Payer: BCBS MAPPO |
$2.56
|
| Rate for Payer: BCBS MAPPO |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$1.40
|
| Rate for Payer: BCBS MAPPO |
$3.49
|
| Rate for Payer: BCBS Trust/PPO |
$11.47
|
| Rate for Payer: BCBS Trust/PPO |
$8.42
|
| Rate for Payer: BCBS Trust/PPO |
$4.60
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCN Commercial |
$11.47
|
| Rate for Payer: BCN Commercial |
$4.60
|
| Rate for Payer: BCN Commercial |
$9.99
|
| Rate for Payer: BCN Commercial |
$8.42
|
| Rate for Payer: BCN Medicare Advantage |
$3.49
|
| Rate for Payer: BCN Medicare Advantage |
$3.04
|
| Rate for Payer: BCN Medicare Advantage |
$1.40
|
| Rate for Payer: BCN Medicare Advantage |
$2.56
|
| Rate for Payer: Cash Price |
$4.48
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$4.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.49
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$5.04
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.68
|
| Rate for Payer: Mclaren Medicaid |
$2.46
|
| Rate for Payer: Mclaren Medicaid |
$2.14
|
| Rate for Payer: Mclaren Medicaid |
$1.81
|
| Rate for Payer: Mclaren Medicaid |
$0.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.69
|
| Rate for Payer: Meridian Medicaid |
$1.90
|
| Rate for Payer: Meridian Medicaid |
$2.58
|
| Rate for Payer: Meridian Medicaid |
$1.04
|
| Rate for Payer: Meridian Medicaid |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.76
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Nomi Health Commercial |
$8.40
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$4.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.68
|
| Rate for Payer: PACE Senior Care Partners |
$3.31
|
| Rate for Payer: PACE Senior Care Partners |
$1.33
|
| Rate for Payer: PACE Senior Care Partners |
$2.43
|
| Rate for Payer: PACE Senior Care Partners |
$2.89
|
| Rate for Payer: PACE SWMI |
$2.56
|
| Rate for Payer: PACE SWMI |
$1.40
|
| Rate for Payer: PACE SWMI |
$3.04
|
| Rate for Payer: PACE SWMI |
$3.49
|
| Rate for Payer: PHP Commercial |
$8.70
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: PHP Commercial |
$4.76
|
| Rate for Payer: PHP Medicare Advantage |
$2.56
|
| Rate for Payer: PHP Medicare Advantage |
$1.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$3.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.91
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health Medicare |
$2.59
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$1.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.93
|
| Rate for Payer: UHC Core |
$8.55
|
| Rate for Payer: UHC Core |
$11.65
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Core |
$4.68
|
| Rate for Payer: UHC Exchange |
$3.49
|
| Rate for Payer: UHC Exchange |
$3.04
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$2.56
|
| Rate for Payer: UHC Medicaid |
$1.81
|
| Rate for Payer: UHC Medicaid |
$2.14
|
| Rate for Payer: UHC Medicaid |
$2.46
|
| Rate for Payer: UHC Medicaid |
$0.99
|
| Rate for Payer: UHC Medicare Advantage |
$3.04
|
| Rate for Payer: UHC Medicare Advantage |
$2.56
|
| Rate for Payer: UHC Medicare Advantage |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$3.49
|
| Rate for Payer: UHCCP Medicaid |
$2.46
|
| Rate for Payer: UHCCP Medicaid |
$0.99
|
| Rate for Payer: UHCCP Medicaid |
$2.14
|
| Rate for Payer: UHCCP Medicaid |
$1.81
|
| Rate for Payer: VA VA |
$2.56
|
| Rate for Payer: VA VA |
$1.40
|
| Rate for Payer: VA VA |
$3.49
|
| Rate for Payer: VA VA |
$3.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.20
|
|
