|
PR OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 26490
|
| Min. Negotiated Rate |
$789.71 |
| Max. Negotiated Rate |
$1,547.00 |
| Rate for Payer: Aetna Commercial |
$1,058.21
|
| Rate for Payer: Aetna Medicare |
$821.30
|
| Rate for Payer: BCBS Complete |
$952.00
|
| Rate for Payer: BCBS MAPPO |
$789.71
|
| Rate for Payer: BCN Medicare Advantage |
$789.71
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$1,137.18
|
| Rate for Payer: Cofinity Commercial |
$1,058.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.20
|
| Rate for Payer: Nomi Health Commercial |
$947.65
|
| Rate for Payer: PACE SWMI |
$789.71
|
| Rate for Payer: PHP Medicare Advantage |
$789.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.00
|
| Rate for Payer: Priority Health Medicare |
$797.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$789.71
|
| Rate for Payer: UHC Exchange |
$789.71
|
| Rate for Payer: UHC Medicare Advantage |
$789.71
|
|
|
PR OPPONENSPLASTY TDN TR W/GRF EA TDN
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 26492
|
| Min. Negotiated Rate |
$616.40 |
| Max. Negotiated Rate |
$1,259.09 |
| Rate for Payer: Aetna Commercial |
$1,171.66
|
| Rate for Payer: Aetna Medicare |
$909.34
|
| Rate for Payer: BCBS Complete |
$616.40
|
| Rate for Payer: BCBS MAPPO |
$874.37
|
| Rate for Payer: BCN Medicare Advantage |
$874.37
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$1,259.09
|
| Rate for Payer: Cofinity Commercial |
$1,171.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$918.09
|
| Rate for Payer: Nomi Health Commercial |
$1,049.24
|
| Rate for Payer: PACE SWMI |
$874.37
|
| Rate for Payer: PHP Medicare Advantage |
$874.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health Medicare |
$883.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$874.37
|
| Rate for Payer: UHC Exchange |
$874.37
|
| Rate for Payer: UHC Medicare Advantage |
$874.37
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.83 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna Medicare |
$92.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.62
|
| Rate for Payer: BCBS Complete |
$142.88
|
| Rate for Payer: BCBS MAPPO |
$89.30
|
| Rate for Payer: BCBS Trust/PPO |
$293.65
|
| Rate for Payer: BCN Commercial |
$277.72
|
| Rate for Payer: BCN Medicare Advantage |
$89.30
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.30
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Nomi Health Commercial |
$292.90
|
| Rate for Payer: PACE Senior Care Partners |
$84.83
|
| Rate for Payer: PACE SWMI |
$89.30
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: PHP Medicare Advantage |
$89.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.18
|
| Rate for Payer: Priority Health HMO/PPO |
$310.76
|
| Rate for Payer: Priority Health Medicare |
$90.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.32
|
| Rate for Payer: Railroad Medicare Medicare |
$89.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.34
|
| Rate for Payer: UHC Core |
$298.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.30
|
| Rate for Payer: UHC Exchange |
$89.30
|
| Rate for Payer: UHC Medicare Advantage |
$89.30
|
| Rate for Payer: VA VA |
$89.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$220.40
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$198.36 |
| Rate for Payer: Aetna Commercial |
$187.34
|
| Rate for Payer: Aetna Medicare |
$57.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.88
|
| Rate for Payer: BCBS Complete |
$88.16
|
| Rate for Payer: BCBS MAPPO |
$55.10
|
| Rate for Payer: BCBS Trust/PPO |
$181.19
|
| Rate for Payer: BCN Commercial |
$171.36
|
| Rate for Payer: BCN Medicare Advantage |
$55.10
|
| Rate for Payer: Cash Price |
$176.32
|
| Rate for Payer: Cofinity Commercial |
$189.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.10
|
| Rate for Payer: Healthscope Commercial |
$198.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.34
|
| Rate for Payer: Nomi Health Commercial |
$180.73
|
| Rate for Payer: PACE Senior Care Partners |
$52.34
|
| Rate for Payer: PACE SWMI |
$55.10
|
| Rate for Payer: PHP Commercial |
$187.34
|
| Rate for Payer: PHP Medicare Advantage |
$55.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.26
|
| Rate for Payer: Priority Health HMO/PPO |
$191.75
|
| Rate for Payer: Priority Health Medicare |
$55.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.67
|
| Rate for Payer: Railroad Medicare Medicare |
$55.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.95
|
| Rate for Payer: UHC Core |
$184.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.10
|
| Rate for Payer: UHC Exchange |
$55.10
|
| Rate for Payer: UHC Medicare Advantage |
$55.10
|
| Rate for Payer: VA VA |
$55.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.30
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$229.12 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: BCBS Trust/PPO |
$287.75
|
| Rate for Payer: BCN Commercial |
$272.41
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Nomi Health Commercial |
$289.05
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health HMO/PPO |
$306.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$294.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.72 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$91.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.16
|
| Rate for Payer: BCBS Complete |
$141.00
|
| Rate for Payer: BCBS MAPPO |
$88.12
|
| Rate for Payer: BCBS Trust/PPO |
$289.79
|
| Rate for Payer: BCN Commercial |
$274.07
|
| Rate for Payer: BCN Medicare Advantage |
$88.12
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.12
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Nomi Health Commercial |
$289.05
|
| Rate for Payer: PACE Senior Care Partners |
$83.72
|
| Rate for Payer: PACE SWMI |
$88.12
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: PHP Medicare Advantage |
$88.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health HMO/PPO |
$306.68
|
| Rate for Payer: Priority Health Medicare |
$89.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.18
|
| Rate for Payer: Railroad Medicare Medicare |
$88.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$294.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.12
|
| Rate for Payer: UHC Exchange |
$88.12
|
| Rate for Payer: UHC Medicare Advantage |
$88.12
|
| Rate for Payer: VA VA |
$88.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$232.18 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: BCBS Trust/PPO |
$291.58
|
| Rate for Payer: BCN Commercial |
$276.04
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Nomi Health Commercial |
$292.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.18
|
| Rate for Payer: Priority Health HMO/PPO |
$310.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.34
|
| Rate for Payer: UHC Core |
$298.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$2.21
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$1.99 |
| Rate for Payer: Aetna Commercial |
$1.88
|
| Rate for Payer: BCBS Trust/PPO |
$1.80
|
| Rate for Payer: BCN Commercial |
$1.71
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: Cofinity Commercial |
$1.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.77
|
| Rate for Payer: Healthscope Commercial |
$1.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.88
|
| Rate for Payer: Nomi Health Commercial |
$1.81
|
| Rate for Payer: PHP Commercial |
$1.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.94
|
| Rate for Payer: UHC Core |
$1.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.66
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$2.21
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$1.99 |
| Rate for Payer: Aetna Commercial |
$1.88
|
| Rate for Payer: Aetna Medicare |
$0.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.69
|
| Rate for Payer: BCBS Complete |
$0.88
|
| Rate for Payer: BCBS MAPPO |
$0.55
|
| Rate for Payer: BCBS Trust/PPO |
$1.82
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Medicare Advantage |
$0.55
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: Cofinity Commercial |
$1.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.55
|
| Rate for Payer: Healthscope Commercial |
$1.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.88
|
| Rate for Payer: Nomi Health Commercial |
$1.81
|
| Rate for Payer: PACE Senior Care Partners |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.55
|
| Rate for Payer: PHP Commercial |
$1.88
|
| Rate for Payer: PHP Medicare Advantage |
$0.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1.92
|
| Rate for Payer: Priority Health Medicare |
$0.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: Railroad Medicare Medicare |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.94
|
| Rate for Payer: UHC Core |
$1.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.55
|
| Rate for Payer: UHC Exchange |
$0.55
|
| Rate for Payer: UHC Medicare Advantage |
$0.55
|
| Rate for Payer: VA VA |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.66
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$220.40
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.26 |
| Max. Negotiated Rate |
$198.36 |
| Rate for Payer: Aetna Commercial |
$187.34
|
| Rate for Payer: BCBS Trust/PPO |
$179.91
|
| Rate for Payer: BCN Commercial |
$170.33
|
| Rate for Payer: Cash Price |
$176.32
|
| Rate for Payer: Cofinity Commercial |
$189.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.32
|
| Rate for Payer: Healthscope Commercial |
$198.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.34
|
| Rate for Payer: Nomi Health Commercial |
$180.73
|
| Rate for Payer: PHP Commercial |
$187.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.26
|
| Rate for Payer: Priority Health HMO/PPO |
$191.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.95
|
| Rate for Payer: UHC Core |
$184.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.30
|
|
|
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$27.86
|
|
|
Service Code
|
HCPCS J1800
|
| Hospital Charge Code |
29335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$25.07 |
| Rate for Payer: Aetna Commercial |
$23.68
|
| Rate for Payer: Aetna Commercial |
$16.89
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Aetna Medicare |
$5.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.21
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS Complete |
$11.14
|
| Rate for Payer: BCBS MAPPO |
$4.97
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$22.90
|
| Rate for Payer: BCBS Trust/PPO |
$16.34
|
| Rate for Payer: BCN Commercial |
$21.66
|
| Rate for Payer: BCN Commercial |
$15.45
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.97
|
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$17.88
|
| Rate for Payer: Healthscope Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.89
|
| Rate for Payer: Nomi Health Commercial |
$22.85
|
| Rate for Payer: Nomi Health Commercial |
$16.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.62
|
| Rate for Payer: PACE Senior Care Partners |
$4.72
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PACE SWMI |
$4.97
|
| Rate for Payer: PHP Commercial |
$23.68
|
| Rate for Payer: PHP Commercial |
$16.89
|
| Rate for Payer: PHP Medicare Advantage |
$4.97
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.92
|
| Rate for Payer: Priority Health HMO/PPO |
$17.29
|
| Rate for Payer: Priority Health HMO/PPO |
$24.24
|
| Rate for Payer: Priority Health Medicare |
$7.03
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.52
|
| Rate for Payer: UHC Core |
$23.26
|
| Rate for Payer: UHC Core |
$16.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.97
|
| Rate for Payer: UHC Exchange |
$4.97
|
| Rate for Payer: UHC Exchange |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$4.97
|
| Rate for Payer: UHC Medicare Advantage |
$6.96
|
| Rate for Payer: VA VA |
$4.97
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.90
|
|
|
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.87
|
|
|
Service Code
|
HCPCS J1800
|
| Hospital Charge Code |
29335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.92 |
| Max. Negotiated Rate |
$17.88 |
| Rate for Payer: Aetna Commercial |
$16.89
|
| Rate for Payer: Aetna Commercial |
$23.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.22
|
| Rate for Payer: BCBS Trust/PPO |
$22.74
|
| Rate for Payer: BCN Commercial |
$15.36
|
| Rate for Payer: BCN Commercial |
$21.53
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Cofinity Commercial |
$23.96
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.90
|
| Rate for Payer: Healthscope Commercial |
$17.88
|
| Rate for Payer: Healthscope Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.68
|
| Rate for Payer: Nomi Health Commercial |
$16.29
|
| Rate for Payer: Nomi Health Commercial |
$22.85
|
| Rate for Payer: PHP Commercial |
$16.89
|
| Rate for Payer: PHP Commercial |
$23.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.92
|
| Rate for Payer: Priority Health HMO/PPO |
$24.24
|
| Rate for Payer: Priority Health HMO/PPO |
$17.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.52
|
| Rate for Payer: UHC Core |
$16.59
|
| Rate for Payer: UHC Core |
$23.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$4.18
|
|
|
Service Code
|
NDC 60687059811
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.99 |
| Max. Negotiated Rate |
$3.76 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$1.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.31
|
| Rate for Payer: BCBS Complete |
$1.67
|
| Rate for Payer: BCBS MAPPO |
$1.04
|
| Rate for Payer: BCBS Trust/PPO |
$3.44
|
| Rate for Payer: BCN Commercial |
$3.25
|
| Rate for Payer: BCN Medicare Advantage |
$1.04
|
| Rate for Payer: Cash Price |
$3.34
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.04
|
| Rate for Payer: Healthscope Commercial |
$3.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.55
|
| Rate for Payer: Nomi Health Commercial |
$3.43
|
| Rate for Payer: PACE Senior Care Partners |
$0.99
|
| Rate for Payer: PACE SWMI |
$1.04
|
| Rate for Payer: PHP Commercial |
$3.55
|
| Rate for Payer: PHP Medicare Advantage |
$1.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3.64
|
| Rate for Payer: Priority Health Medicare |
$1.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.68
|
| Rate for Payer: UHC Core |
$3.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.04
|
| Rate for Payer: UHC Exchange |
$1.04
|
| Rate for Payer: UHC Medicare Advantage |
$1.04
|
| Rate for Payer: VA VA |
$1.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.13
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$223.73
|
|
|
Service Code
|
NDC 50268070115
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.42 |
| Max. Negotiated Rate |
$201.36 |
| Rate for Payer: Aetna Commercial |
$190.17
|
| Rate for Payer: BCBS Trust/PPO |
$182.63
|
| Rate for Payer: BCN Commercial |
$172.90
|
| Rate for Payer: Cash Price |
$178.98
|
| Rate for Payer: Cofinity Commercial |
$192.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.98
|
| Rate for Payer: Healthscope Commercial |
$201.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.17
|
| Rate for Payer: Nomi Health Commercial |
$183.46
|
| Rate for Payer: PHP Commercial |
$190.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.42
|
| Rate for Payer: Priority Health HMO/PPO |
$194.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.88
|
| Rate for Payer: UHC Core |
$186.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.80
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$4.18
|
|
|
Service Code
|
NDC 60687059811
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$3.76 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: BCBS Trust/PPO |
$3.41
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$3.34
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.34
|
| Rate for Payer: Healthscope Commercial |
$3.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.55
|
| Rate for Payer: Nomi Health Commercial |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.68
|
| Rate for Payer: UHC Core |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.13
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$417.05
|
|
|
Service Code
|
NDC 60687059801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.05 |
| Max. Negotiated Rate |
$375.35 |
| Rate for Payer: Aetna Commercial |
$354.49
|
| Rate for Payer: Aetna Medicare |
$108.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.33
|
| Rate for Payer: BCBS Complete |
$166.82
|
| Rate for Payer: BCBS MAPPO |
$104.26
|
| Rate for Payer: BCBS Trust/PPO |
$342.86
|
| Rate for Payer: BCN Commercial |
$324.26
|
| Rate for Payer: BCN Medicare Advantage |
$104.26
|
| Rate for Payer: Cash Price |
$333.64
|
| Rate for Payer: Cofinity Commercial |
$358.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.49
|
| Rate for Payer: Nomi Health Commercial |
$341.98
|
| Rate for Payer: PACE Senior Care Partners |
$99.05
|
| Rate for Payer: PACE SWMI |
$104.26
|
| Rate for Payer: PHP Commercial |
$354.49
|
| Rate for Payer: PHP Medicare Advantage |
$104.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.08
|
| Rate for Payer: Priority Health HMO/PPO |
$362.83
|
| Rate for Payer: Priority Health Medicare |
$105.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.42
|
| Rate for Payer: Railroad Medicare Medicare |
$104.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.00
|
| Rate for Payer: UHC Core |
$348.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.26
|
| Rate for Payer: UHC Exchange |
$104.26
|
| Rate for Payer: UHC Medicare Advantage |
$104.26
|
| Rate for Payer: VA VA |
$104.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.79
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$165.78
|
|
|
Service Code
|
NDC 00904670506
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.76 |
| Max. Negotiated Rate |
$149.20 |
| Rate for Payer: Aetna Commercial |
$140.91
|
| Rate for Payer: BCBS Trust/PPO |
$135.33
|
| Rate for Payer: BCN Commercial |
$128.11
|
| Rate for Payer: Cash Price |
$132.62
|
| Rate for Payer: Cofinity Commercial |
$142.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.62
|
| Rate for Payer: Healthscope Commercial |
$149.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.91
|
| Rate for Payer: Nomi Health Commercial |
$135.94
|
| Rate for Payer: PHP Commercial |
$140.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.76
|
| Rate for Payer: Priority Health HMO/PPO |
$144.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.89
|
| Rate for Payer: UHC Core |
$138.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.33
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$223.73
|
|
|
Service Code
|
NDC 50268070115
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.14 |
| Max. Negotiated Rate |
$201.36 |
| Rate for Payer: Aetna Commercial |
$190.17
|
| Rate for Payer: Aetna Medicare |
$58.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.92
|
| Rate for Payer: BCBS Complete |
$89.49
|
| Rate for Payer: BCBS MAPPO |
$55.93
|
| Rate for Payer: BCBS Trust/PPO |
$183.93
|
| Rate for Payer: BCN Commercial |
$173.95
|
| Rate for Payer: BCN Medicare Advantage |
$55.93
|
| Rate for Payer: Cash Price |
$178.98
|
| Rate for Payer: Cofinity Commercial |
$192.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.93
|
| Rate for Payer: Healthscope Commercial |
$201.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.17
|
| Rate for Payer: Nomi Health Commercial |
$183.46
|
| Rate for Payer: PACE Senior Care Partners |
$53.14
|
| Rate for Payer: PACE SWMI |
$55.93
|
| Rate for Payer: PHP Commercial |
$190.17
|
| Rate for Payer: PHP Medicare Advantage |
$55.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.42
|
| Rate for Payer: Priority Health HMO/PPO |
$194.65
|
| Rate for Payer: Priority Health Medicare |
$56.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.90
|
| Rate for Payer: Railroad Medicare Medicare |
$55.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.88
|
| Rate for Payer: UHC Core |
$186.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.93
|
| Rate for Payer: UHC Exchange |
$55.93
|
| Rate for Payer: UHC Medicare Advantage |
$55.93
|
| Rate for Payer: VA VA |
$55.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.80
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$165.78
|
|
|
Service Code
|
NDC 00904670506
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.37 |
| Max. Negotiated Rate |
$149.20 |
| Rate for Payer: Aetna Commercial |
$140.91
|
| Rate for Payer: Aetna Medicare |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.81
|
| Rate for Payer: BCBS Complete |
$66.31
|
| Rate for Payer: BCBS MAPPO |
$41.45
|
| Rate for Payer: BCBS Trust/PPO |
$136.29
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: BCN Medicare Advantage |
$41.45
|
| Rate for Payer: Cash Price |
$132.62
|
| Rate for Payer: Cofinity Commercial |
$142.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.45
|
| Rate for Payer: Healthscope Commercial |
$149.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.91
|
| Rate for Payer: Nomi Health Commercial |
$135.94
|
| Rate for Payer: PACE Senior Care Partners |
$39.37
|
| Rate for Payer: PACE SWMI |
$41.45
|
| Rate for Payer: PHP Commercial |
$140.91
|
| Rate for Payer: PHP Medicare Advantage |
$41.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.76
|
| Rate for Payer: Priority Health HMO/PPO |
$144.23
|
| Rate for Payer: Priority Health Medicare |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.07
|
| Rate for Payer: Railroad Medicare Medicare |
$41.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.89
|
| Rate for Payer: UHC Core |
$138.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.45
|
| Rate for Payer: UHC Exchange |
$41.45
|
| Rate for Payer: UHC Medicare Advantage |
$41.45
|
| Rate for Payer: VA VA |
$41.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.33
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$315.40
|
|
|
Service Code
|
NDC 00378018301
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$205.01 |
| Max. Negotiated Rate |
$283.86 |
| Rate for Payer: Aetna Commercial |
$268.09
|
| Rate for Payer: BCBS Trust/PPO |
$257.46
|
| Rate for Payer: BCN Commercial |
$243.74
|
| Rate for Payer: Cash Price |
$252.32
|
| Rate for Payer: Cofinity Commercial |
$271.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.32
|
| Rate for Payer: Healthscope Commercial |
$283.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.09
|
| Rate for Payer: Nomi Health Commercial |
$258.63
|
| Rate for Payer: PHP Commercial |
$268.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.01
|
| Rate for Payer: Priority Health HMO/PPO |
$274.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.55
|
| Rate for Payer: UHC Core |
$263.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.55
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$315.40
|
|
|
Service Code
|
NDC 00378018301
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.91 |
| Max. Negotiated Rate |
$283.86 |
| Rate for Payer: Aetna Commercial |
$268.09
|
| Rate for Payer: Aetna Medicare |
$82.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.56
|
| Rate for Payer: BCBS Complete |
$126.16
|
| Rate for Payer: BCBS MAPPO |
$78.85
|
| Rate for Payer: BCBS Trust/PPO |
$259.29
|
| Rate for Payer: BCN Commercial |
$245.22
|
| Rate for Payer: BCN Medicare Advantage |
$78.85
|
| Rate for Payer: Cash Price |
$252.32
|
| Rate for Payer: Cofinity Commercial |
$271.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.85
|
| Rate for Payer: Healthscope Commercial |
$283.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.09
|
| Rate for Payer: Nomi Health Commercial |
$258.63
|
| Rate for Payer: PACE Senior Care Partners |
$74.91
|
| Rate for Payer: PACE SWMI |
$78.85
|
| Rate for Payer: PHP Commercial |
$268.09
|
| Rate for Payer: PHP Medicare Advantage |
$78.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.01
|
| Rate for Payer: Priority Health HMO/PPO |
$274.40
|
| Rate for Payer: Priority Health Medicare |
$79.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.32
|
| Rate for Payer: Railroad Medicare Medicare |
$78.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.55
|
| Rate for Payer: UHC Core |
$263.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.85
|
| Rate for Payer: UHC Exchange |
$78.85
|
| Rate for Payer: UHC Medicare Advantage |
$78.85
|
| Rate for Payer: VA VA |
$78.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.55
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$4.48
|
|
|
Service Code
|
NDC 50268070111
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Aetna Commercial |
$3.81
|
| Rate for Payer: Aetna Medicare |
$1.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.40
|
| Rate for Payer: BCBS Complete |
$1.79
|
| Rate for Payer: BCBS MAPPO |
$1.12
|
| Rate for Payer: BCBS Trust/PPO |
$3.68
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$1.12
|
| Rate for Payer: Cash Price |
$3.58
|
| Rate for Payer: Cofinity Commercial |
$3.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.12
|
| Rate for Payer: Healthscope Commercial |
$4.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.81
|
| Rate for Payer: Nomi Health Commercial |
$3.67
|
| Rate for Payer: PACE Senior Care Partners |
$1.06
|
| Rate for Payer: PACE SWMI |
$1.12
|
| Rate for Payer: PHP Commercial |
$3.81
|
| Rate for Payer: PHP Medicare Advantage |
$1.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.91
|
| Rate for Payer: Priority Health HMO/PPO |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$1.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.94
|
| Rate for Payer: UHC Core |
$3.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.12
|
| Rate for Payer: UHC Exchange |
$1.12
|
| Rate for Payer: UHC Medicare Advantage |
$1.12
|
| Rate for Payer: VA VA |
$1.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.36
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$4.48
|
|
|
Service Code
|
NDC 50268070111
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Aetna Commercial |
$3.81
|
| Rate for Payer: BCBS Trust/PPO |
$3.66
|
| Rate for Payer: BCN Commercial |
$3.46
|
| Rate for Payer: Cash Price |
$3.58
|
| Rate for Payer: Cofinity Commercial |
$3.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$4.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.81
|
| Rate for Payer: Nomi Health Commercial |
$3.67
|
| Rate for Payer: PHP Commercial |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.91
|
| Rate for Payer: Priority Health HMO/PPO |
$3.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.94
|
| Rate for Payer: UHC Core |
$3.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.36
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$417.05
|
|
|
Service Code
|
NDC 60687059801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$271.08 |
| Max. Negotiated Rate |
$375.35 |
| Rate for Payer: Aetna Commercial |
$354.49
|
| Rate for Payer: BCBS Trust/PPO |
$340.44
|
| Rate for Payer: BCN Commercial |
$322.30
|
| Rate for Payer: Cash Price |
$333.64
|
| Rate for Payer: Cofinity Commercial |
$358.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.64
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.49
|
| Rate for Payer: Nomi Health Commercial |
$341.98
|
| Rate for Payer: PHP Commercial |
$354.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.08
|
| Rate for Payer: Priority Health HMO/PPO |
$362.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.00
|
| Rate for Payer: UHC Core |
$348.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.79
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$279.30
|
|
|
Service Code
|
NDC 00904670561
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.33 |
| Max. Negotiated Rate |
$251.37 |
| Rate for Payer: Aetna Commercial |
$237.41
|
| Rate for Payer: Aetna Medicare |
$72.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.28
|
| Rate for Payer: BCBS Complete |
$111.72
|
| Rate for Payer: BCBS MAPPO |
$69.83
|
| Rate for Payer: BCBS Trust/PPO |
$229.61
|
| Rate for Payer: BCN Commercial |
$217.16
|
| Rate for Payer: BCN Medicare Advantage |
$69.83
|
| Rate for Payer: Cash Price |
$223.44
|
| Rate for Payer: Cofinity Commercial |
$240.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$251.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.41
|
| Rate for Payer: Nomi Health Commercial |
$229.03
|
| Rate for Payer: PACE Senior Care Partners |
$66.33
|
| Rate for Payer: PACE SWMI |
$69.83
|
| Rate for Payer: PHP Commercial |
$237.41
|
| Rate for Payer: PHP Medicare Advantage |
$69.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.54
|
| Rate for Payer: Priority Health HMO/PPO |
$242.99
|
| Rate for Payer: Priority Health Medicare |
$70.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.13
|
| Rate for Payer: Railroad Medicare Medicare |
$69.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.78
|
| Rate for Payer: UHC Core |
$233.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.83
|
| Rate for Payer: UHC Exchange |
$69.83
|
| Rate for Payer: UHC Medicare Advantage |
$69.83
|
| Rate for Payer: VA VA |
$69.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.47
|
|
