|
POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 00338069504
|
| Hospital Charge Code |
11082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.44 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.95
|
| Rate for Payer: BCBS Complete |
$8.86
|
| Rate for Payer: BCBS MAPPO |
$11.96
|
| Rate for Payer: BCBS Trust/PPO |
$39.34
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$11.96
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.96
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Mclaren Medicaid |
$8.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.56
|
| Rate for Payer: Meridian Medicaid |
$8.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: PACE Senior Care Partners |
$11.36
|
| Rate for Payer: PACE SWMI |
$11.96
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: PHP Medicare Advantage |
$11.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.63
|
| Rate for Payer: Priority Health Medicare |
$12.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$39.95
|
| Rate for Payer: UHC Exchange |
$11.96
|
| Rate for Payer: UHC Medicaid |
$8.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.96
|
| Rate for Payer: UHCCP Medicaid |
$8.44
|
| Rate for Payer: VA VA |
$11.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$111.65
|
|
|
Service Code
|
NDC 00990711609
|
| Hospital Charge Code |
11082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.71 |
| Max. Negotiated Rate |
$100.48 |
| Rate for Payer: Aetna Commercial |
$94.90
|
| Rate for Payer: BCBS Trust/PPO |
$92.21
|
| Rate for Payer: BCN Commercial |
$92.21
|
| Rate for Payer: Cash Price |
$89.32
|
| Rate for Payer: Cofinity Commercial |
$96.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.32
|
| Rate for Payer: Healthscope Commercial |
$100.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.90
|
| Rate for Payer: Nomi Health Commercial |
$91.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.74
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.25
|
| Rate for Payer: UHC Core |
$93.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.74
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.28
|
|
|
Service Code
|
NDC 60687081011
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: Aetna Medicare |
$0.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.71
|
| Rate for Payer: BCBS Complete |
$0.42
|
| Rate for Payer: BCBS MAPPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$1.87
|
| Rate for Payer: BCN Commercial |
$1.87
|
| Rate for Payer: BCN Medicare Advantage |
$0.57
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.57
|
| Rate for Payer: Healthscope Commercial |
$2.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.71
|
| Rate for Payer: Mclaren Medicaid |
$0.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.60
|
| Rate for Payer: Meridian Medicaid |
$0.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.94
|
| Rate for Payer: Nomi Health Commercial |
$1.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.71
|
| Rate for Payer: PACE Senior Care Partners |
$0.54
|
| Rate for Payer: PACE SWMI |
$0.57
|
| Rate for Payer: PHP Commercial |
$1.94
|
| Rate for Payer: PHP Medicare Advantage |
$0.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.98
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.59
|
| Rate for Payer: Railroad Medicare Medicare |
$0.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.01
|
| Rate for Payer: UHC Core |
$1.90
|
| Rate for Payer: UHC Exchange |
$0.57
|
| Rate for Payer: UHC Medicaid |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.57
|
| Rate for Payer: UHCCP Medicaid |
$0.40
|
| Rate for Payer: VA VA |
$0.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.71
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2,914.00
|
|
|
Service Code
|
NDC 72888007500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,028.14 |
| Max. Negotiated Rate |
$2,622.60 |
| Rate for Payer: Aetna Commercial |
$2,476.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.67
|
| Rate for Payer: BCN Commercial |
$2,406.67
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cofinity Commercial |
$2,506.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,331.20
|
| Rate for Payer: Healthscope Commercial |
$2,622.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,185.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,476.90
|
| Rate for Payer: Nomi Health Commercial |
$2,389.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,185.50
|
| Rate for Payer: PHP Commercial |
$2,476.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,535.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,028.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,564.32
|
| Rate for Payer: UHC Core |
$2,433.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,185.50
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$286.90
|
|
|
Service Code
|
NDC 00574027511
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.58 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: Aetna Medicare |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.66
|
| Rate for Payer: BCBS Complete |
$53.11
|
| Rate for Payer: BCBS MAPPO |
$71.72
|
| Rate for Payer: BCBS Trust/PPO |
$235.86
|
| Rate for Payer: BCN Commercial |
$235.86
|
| Rate for Payer: BCN Medicare Advantage |
$71.72
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.72
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Mclaren Medicaid |
$50.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.31
|
| Rate for Payer: Meridian Medicaid |
$53.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Nomi Health Commercial |
$235.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PACE Senior Care Partners |
$68.14
|
| Rate for Payer: PACE SWMI |
$71.72
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: PHP Medicare Advantage |
$71.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.60
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.68
|
| Rate for Payer: Railroad Medicare Medicare |
$71.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.47
|
| Rate for Payer: UHC Core |
$239.56
|
| Rate for Payer: UHC Exchange |
$71.72
|
| Rate for Payer: UHC Medicaid |
$50.58
|
| Rate for Payer: UHC Medicare Advantage |
$71.72
|
| Rate for Payer: UHCCP Medicaid |
$50.58
|
| Rate for Payer: VA VA |
$71.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$265.55
|
|
|
Service Code
|
NDC 00245531601
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.82 |
| Max. Negotiated Rate |
$239.00 |
| Rate for Payer: Aetna Commercial |
$225.72
|
| Rate for Payer: Aetna Medicare |
$69.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.98
|
| Rate for Payer: BCBS Complete |
$49.15
|
| Rate for Payer: BCBS MAPPO |
$66.39
|
| Rate for Payer: BCBS Trust/PPO |
$218.31
|
| Rate for Payer: BCN Commercial |
$218.31
|
| Rate for Payer: BCN Medicare Advantage |
$66.39
|
| Rate for Payer: Cash Price |
$212.44
|
| Rate for Payer: Cofinity Commercial |
$228.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.39
|
| Rate for Payer: Healthscope Commercial |
$239.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.16
|
| Rate for Payer: Mclaren Medicaid |
$46.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.71
|
| Rate for Payer: Meridian Medicaid |
$49.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.72
|
| Rate for Payer: Nomi Health Commercial |
$217.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.16
|
| Rate for Payer: PACE Senior Care Partners |
$63.07
|
| Rate for Payer: PACE SWMI |
$66.39
|
| Rate for Payer: PHP Commercial |
$225.72
|
| Rate for Payer: PHP Medicare Advantage |
$66.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.03
|
| Rate for Payer: Priority Health Medicare |
$67.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.82
|
| Rate for Payer: Railroad Medicare Medicare |
$66.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.68
|
| Rate for Payer: UHC Core |
$221.73
|
| Rate for Payer: UHC Exchange |
$66.39
|
| Rate for Payer: UHC Medicaid |
$46.82
|
| Rate for Payer: UHC Medicare Advantage |
$66.39
|
| Rate for Payer: UHCCP Medicaid |
$46.82
|
| Rate for Payer: VA VA |
$66.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.16
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$284.35
|
|
|
Service Code
|
NDC 72888007501
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$197.91 |
| Max. Negotiated Rate |
$255.91 |
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: BCBS Trust/PPO |
$234.84
|
| Rate for Payer: BCN Commercial |
$234.84
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Healthscope Commercial |
$255.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.70
|
| Rate for Payer: Nomi Health Commercial |
$233.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.26
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.23
|
| Rate for Payer: UHC Core |
$237.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.87
|
|
|
Service Code
|
NDC 00574027500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.44
|
| Rate for Payer: BCBS Trust/PPO |
$2.37
|
| Rate for Payer: BCN Commercial |
$2.37
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Healthscope Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Nomi Health Commercial |
$2.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: PHP Commercial |
$2.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.53
|
| Rate for Payer: UHC Core |
$2.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.15
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.66
|
|
|
Service Code
|
NDC 00245531689
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$2.39 |
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: BCBS Trust/PPO |
$2.20
|
| Rate for Payer: BCN Commercial |
$2.20
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Nomi Health Commercial |
$2.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.34
|
| Rate for Payer: UHC Core |
$2.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.66
|
|
|
Service Code
|
NDC 00245531689
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$2.39 |
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna Medicare |
$0.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.83
|
| Rate for Payer: BCBS Complete |
$0.49
|
| Rate for Payer: BCBS MAPPO |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$2.19
|
| Rate for Payer: BCN Commercial |
$2.19
|
| Rate for Payer: BCN Medicare Advantage |
$0.67
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.67
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: Mclaren Medicaid |
$0.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: Meridian Medicaid |
$0.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Nomi Health Commercial |
$2.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: PACE Senior Care Partners |
$0.63
|
| Rate for Payer: PACE SWMI |
$0.67
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: PHP Medicare Advantage |
$0.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Medicare |
$0.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.85
|
| Rate for Payer: Railroad Medicare Medicare |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.34
|
| Rate for Payer: UHC Core |
$2.22
|
| Rate for Payer: UHC Exchange |
$0.67
|
| Rate for Payer: UHC Medicaid |
$0.47
|
| Rate for Payer: UHC Medicare Advantage |
$0.67
|
| Rate for Payer: UHCCP Medicaid |
$0.47
|
| Rate for Payer: VA VA |
$0.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$227.05
|
|
|
Service Code
|
NDC 00904721661
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.03 |
| Max. Negotiated Rate |
$204.34 |
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: BCBS Trust/PPO |
$187.52
|
| Rate for Payer: BCN Commercial |
$187.52
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: Nomi Health Commercial |
$186.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.29
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.80
|
| Rate for Payer: UHC Core |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.87
|
|
|
Service Code
|
NDC 00574027500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.44
|
| Rate for Payer: Aetna Medicare |
$0.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.90
|
| Rate for Payer: BCBS Complete |
$0.53
|
| Rate for Payer: BCBS MAPPO |
$0.72
|
| Rate for Payer: BCBS Trust/PPO |
$2.36
|
| Rate for Payer: BCN Commercial |
$2.36
|
| Rate for Payer: BCN Medicare Advantage |
$0.72
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.72
|
| Rate for Payer: Healthscope Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.15
|
| Rate for Payer: Mclaren Medicaid |
$0.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.75
|
| Rate for Payer: Meridian Medicaid |
$0.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Nomi Health Commercial |
$2.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: PACE Senior Care Partners |
$0.68
|
| Rate for Payer: PACE SWMI |
$0.72
|
| Rate for Payer: PHP Commercial |
$2.44
|
| Rate for Payer: PHP Medicare Advantage |
$0.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.50
|
| Rate for Payer: Priority Health Medicare |
$0.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.00
|
| Rate for Payer: Railroad Medicare Medicare |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.53
|
| Rate for Payer: UHC Core |
$2.40
|
| Rate for Payer: UHC Exchange |
$0.72
|
| Rate for Payer: UHC Medicaid |
$0.51
|
| Rate for Payer: UHC Medicare Advantage |
$0.72
|
| Rate for Payer: UHCCP Medicaid |
$0.51
|
| Rate for Payer: VA VA |
$0.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.15
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$286.90
|
|
|
Service Code
|
NDC 00574027511
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$199.68 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: BCBS Trust/PPO |
$236.95
|
| Rate for Payer: BCN Commercial |
$236.95
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Nomi Health Commercial |
$235.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.47
|
| Rate for Payer: UHC Core |
$239.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$260.85
|
|
|
Service Code
|
NDC 00832532311
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$181.55 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna Commercial |
$221.72
|
| Rate for Payer: BCBS Trust/PPO |
$215.44
|
| Rate for Payer: BCN Commercial |
$215.44
|
| Rate for Payer: Cash Price |
$208.68
|
| Rate for Payer: Cofinity Commercial |
$224.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.68
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.72
|
| Rate for Payer: Nomi Health Commercial |
$213.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.64
|
| Rate for Payer: PHP Commercial |
$221.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.55
|
| Rate for Payer: UHC Core |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.64
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.28
|
|
|
Service Code
|
NDC 60687081011
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: BCBS Trust/PPO |
$1.88
|
| Rate for Payer: BCN Commercial |
$1.88
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$2.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.94
|
| Rate for Payer: Nomi Health Commercial |
$1.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.71
|
| Rate for Payer: PHP Commercial |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.01
|
| Rate for Payer: UHC Core |
$1.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.71
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$181.64
|
|
|
Service Code
|
NDC 60687081009
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.02 |
| Max. Negotiated Rate |
$163.48 |
| Rate for Payer: Aetna Commercial |
$154.39
|
| Rate for Payer: Aetna Medicare |
$47.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.76
|
| Rate for Payer: BCBS Complete |
$33.62
|
| Rate for Payer: BCBS MAPPO |
$45.41
|
| Rate for Payer: BCBS Trust/PPO |
$149.33
|
| Rate for Payer: BCN Commercial |
$149.33
|
| Rate for Payer: BCN Medicare Advantage |
$45.41
|
| Rate for Payer: Cash Price |
$145.31
|
| Rate for Payer: Cofinity Commercial |
$156.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.41
|
| Rate for Payer: Healthscope Commercial |
$163.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.23
|
| Rate for Payer: Mclaren Medicaid |
$32.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.68
|
| Rate for Payer: Meridian Medicaid |
$33.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.39
|
| Rate for Payer: Nomi Health Commercial |
$148.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.23
|
| Rate for Payer: PACE Senior Care Partners |
$43.14
|
| Rate for Payer: PACE SWMI |
$45.41
|
| Rate for Payer: PHP Commercial |
$154.39
|
| Rate for Payer: PHP Medicare Advantage |
$45.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.03
|
| Rate for Payer: Priority Health Medicare |
$45.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.42
|
| Rate for Payer: Railroad Medicare Medicare |
$45.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.84
|
| Rate for Payer: UHC Core |
$151.67
|
| Rate for Payer: UHC Exchange |
$45.41
|
| Rate for Payer: UHC Medicaid |
$32.02
|
| Rate for Payer: UHC Medicare Advantage |
$45.41
|
| Rate for Payer: UHCCP Medicaid |
$32.02
|
| Rate for Payer: VA VA |
$45.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.23
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$284.35
|
|
|
Service Code
|
NDC 72888007501
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$255.91 |
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: Aetna Medicare |
$73.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.86
|
| Rate for Payer: BCBS Complete |
$52.63
|
| Rate for Payer: BCBS MAPPO |
$71.09
|
| Rate for Payer: BCBS Trust/PPO |
$233.76
|
| Rate for Payer: BCN Commercial |
$233.76
|
| Rate for Payer: BCN Medicare Advantage |
$71.09
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.09
|
| Rate for Payer: Healthscope Commercial |
$255.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Mclaren Medicaid |
$50.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.64
|
| Rate for Payer: Meridian Medicaid |
$52.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.70
|
| Rate for Payer: Nomi Health Commercial |
$233.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.26
|
| Rate for Payer: PACE Senior Care Partners |
$67.53
|
| Rate for Payer: PACE SWMI |
$71.09
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.38
|
| Rate for Payer: Priority Health Medicare |
$71.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.23
|
| Rate for Payer: UHC Core |
$237.43
|
| Rate for Payer: UHC Exchange |
$71.09
|
| Rate for Payer: UHC Medicaid |
$50.13
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: UHCCP Medicaid |
$50.13
|
| Rate for Payer: VA VA |
$71.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$227.05
|
|
|
Service Code
|
NDC 00904721661
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.03 |
| Max. Negotiated Rate |
$204.34 |
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: Aetna Medicare |
$59.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.95
|
| Rate for Payer: BCBS Complete |
$42.03
|
| Rate for Payer: BCBS MAPPO |
$56.76
|
| Rate for Payer: BCBS Trust/PPO |
$186.66
|
| Rate for Payer: BCN Commercial |
$186.66
|
| Rate for Payer: BCN Medicare Advantage |
$56.76
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.76
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: Mclaren Medicaid |
$40.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.60
|
| Rate for Payer: Meridian Medicaid |
$42.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: Nomi Health Commercial |
$186.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.29
|
| Rate for Payer: PACE Senior Care Partners |
$53.92
|
| Rate for Payer: PACE SWMI |
$56.76
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: PHP Medicare Advantage |
$56.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.53
|
| Rate for Payer: Priority Health Medicare |
$57.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.03
|
| Rate for Payer: Railroad Medicare Medicare |
$56.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.80
|
| Rate for Payer: UHC Core |
$189.59
|
| Rate for Payer: UHC Exchange |
$56.76
|
| Rate for Payer: UHC Medicaid |
$40.03
|
| Rate for Payer: UHC Medicare Advantage |
$56.76
|
| Rate for Payer: UHCCP Medicaid |
$40.03
|
| Rate for Payer: VA VA |
$56.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2,914.00
|
|
|
Service Code
|
NDC 72888007500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$513.74 |
| Max. Negotiated Rate |
$2,622.60 |
| Rate for Payer: Aetna Commercial |
$2,476.90
|
| Rate for Payer: Aetna Medicare |
$757.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$910.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$910.62
|
| Rate for Payer: BCBS Complete |
$539.38
|
| Rate for Payer: BCBS MAPPO |
$728.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,395.60
|
| Rate for Payer: BCN Commercial |
$2,395.60
|
| Rate for Payer: BCN Medicare Advantage |
$728.50
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cofinity Commercial |
$2,506.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,331.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.50
|
| Rate for Payer: Healthscope Commercial |
$2,622.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,185.50
|
| Rate for Payer: Mclaren Medicaid |
$513.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.92
|
| Rate for Payer: Meridian Medicaid |
$539.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$837.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,476.90
|
| Rate for Payer: Nomi Health Commercial |
$2,389.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,185.50
|
| Rate for Payer: PACE Senior Care Partners |
$692.08
|
| Rate for Payer: PACE SWMI |
$728.50
|
| Rate for Payer: PHP Commercial |
$2,476.90
|
| Rate for Payer: PHP Medicare Advantage |
$728.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,535.18
|
| Rate for Payer: Priority Health Medicare |
$735.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,028.14
|
| Rate for Payer: Railroad Medicare Medicare |
$728.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,564.32
|
| Rate for Payer: UHC Core |
$2,433.19
|
| Rate for Payer: UHC Exchange |
$728.50
|
| Rate for Payer: UHC Medicaid |
$513.74
|
| Rate for Payer: UHC Medicare Advantage |
$728.50
|
| Rate for Payer: UHCCP Medicaid |
$513.74
|
| Rate for Payer: VA VA |
$728.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,185.50
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$260.85
|
|
|
Service Code
|
NDC 00832532311
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna Commercial |
$221.72
|
| Rate for Payer: Aetna Medicare |
$67.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.52
|
| Rate for Payer: BCBS Complete |
$48.28
|
| Rate for Payer: BCBS MAPPO |
$65.21
|
| Rate for Payer: BCBS Trust/PPO |
$214.44
|
| Rate for Payer: BCN Commercial |
$214.44
|
| Rate for Payer: BCN Medicare Advantage |
$65.21
|
| Rate for Payer: Cash Price |
$208.68
|
| Rate for Payer: Cofinity Commercial |
$224.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.21
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.64
|
| Rate for Payer: Mclaren Medicaid |
$45.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.47
|
| Rate for Payer: Meridian Medicaid |
$48.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.72
|
| Rate for Payer: Nomi Health Commercial |
$213.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.64
|
| Rate for Payer: PACE Senior Care Partners |
$61.95
|
| Rate for Payer: PACE SWMI |
$65.21
|
| Rate for Payer: PHP Commercial |
$221.72
|
| Rate for Payer: PHP Medicare Advantage |
$65.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.94
|
| Rate for Payer: Priority Health Medicare |
$65.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.55
|
| Rate for Payer: Railroad Medicare Medicare |
$65.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.55
|
| Rate for Payer: UHC Core |
$217.81
|
| Rate for Payer: UHC Exchange |
$65.21
|
| Rate for Payer: UHC Medicaid |
$45.99
|
| Rate for Payer: UHC Medicare Advantage |
$65.21
|
| Rate for Payer: UHCCP Medicaid |
$45.99
|
| Rate for Payer: VA VA |
$65.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.64
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$265.55
|
|
|
Service Code
|
NDC 00245531601
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.82 |
| Max. Negotiated Rate |
$239.00 |
| Rate for Payer: Aetna Commercial |
$225.72
|
| Rate for Payer: BCBS Trust/PPO |
$219.32
|
| Rate for Payer: BCN Commercial |
$219.32
|
| Rate for Payer: Cash Price |
$212.44
|
| Rate for Payer: Cofinity Commercial |
$228.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.44
|
| Rate for Payer: Healthscope Commercial |
$239.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.72
|
| Rate for Payer: Nomi Health Commercial |
$217.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.16
|
| Rate for Payer: PHP Commercial |
$225.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.68
|
| Rate for Payer: UHC Core |
$221.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.16
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$181.64
|
|
|
Service Code
|
NDC 60687081009
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.42 |
| Max. Negotiated Rate |
$163.48 |
| Rate for Payer: Aetna Commercial |
$154.39
|
| Rate for Payer: BCBS Trust/PPO |
$150.02
|
| Rate for Payer: BCN Commercial |
$150.02
|
| Rate for Payer: Cash Price |
$145.31
|
| Rate for Payer: Cofinity Commercial |
$156.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.31
|
| Rate for Payer: Healthscope Commercial |
$163.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.39
|
| Rate for Payer: Nomi Health Commercial |
$148.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.23
|
| Rate for Payer: PHP Commercial |
$154.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.84
|
| Rate for Payer: UHC Core |
$151.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.23
|
|
|
POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN
|
Facility
|
IP
|
$99.02
|
|
|
Service Code
|
NDC 65219065825
|
| Hospital Charge Code |
151984
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$68.92 |
| Max. Negotiated Rate |
$89.12 |
| Rate for Payer: Aetna Commercial |
$84.17
|
| Rate for Payer: BCBS Trust/PPO |
$81.78
|
| Rate for Payer: BCN Commercial |
$81.78
|
| Rate for Payer: Cash Price |
$79.22
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.22
|
| Rate for Payer: Healthscope Commercial |
$89.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.17
|
| Rate for Payer: Nomi Health Commercial |
$81.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.27
|
| Rate for Payer: PHP Commercial |
$84.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.14
|
| Rate for Payer: UHC Core |
$82.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.27
|
|
|
POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN
|
Facility
|
OP
|
$99.02
|
|
|
Service Code
|
NDC 65219065825
|
| Hospital Charge Code |
151984
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$89.12 |
| Rate for Payer: Aetna Commercial |
$84.17
|
| Rate for Payer: Aetna Medicare |
$25.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.94
|
| Rate for Payer: BCBS Complete |
$18.33
|
| Rate for Payer: BCBS MAPPO |
$24.75
|
| Rate for Payer: BCBS Trust/PPO |
$81.40
|
| Rate for Payer: BCN Commercial |
$81.40
|
| Rate for Payer: BCN Medicare Advantage |
$24.75
|
| Rate for Payer: Cash Price |
$79.22
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.75
|
| Rate for Payer: Healthscope Commercial |
$89.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.27
|
| Rate for Payer: Mclaren Medicaid |
$17.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.99
|
| Rate for Payer: Meridian Medicaid |
$18.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.17
|
| Rate for Payer: Nomi Health Commercial |
$81.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.27
|
| Rate for Payer: PACE Senior Care Partners |
$23.52
|
| Rate for Payer: PACE SWMI |
$24.75
|
| Rate for Payer: PHP Commercial |
$84.17
|
| Rate for Payer: PHP Medicare Advantage |
$24.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.15
|
| Rate for Payer: Priority Health Medicare |
$25.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: Railroad Medicare Medicare |
$24.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.14
|
| Rate for Payer: UHC Core |
$82.68
|
| Rate for Payer: UHC Exchange |
$24.75
|
| Rate for Payer: UHC Medicaid |
$17.46
|
| Rate for Payer: UHC Medicare Advantage |
$24.75
|
| Rate for Payer: UHCCP Medicaid |
$17.46
|
| Rate for Payer: VA VA |
$24.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.27
|
|
|
POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
NDC 70121172201
|
| Hospital Charge Code |
151984
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
