|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$42.30
|
|
|
Service Code
|
NDC 68382011214
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.44 |
| Max. Negotiated Rate |
$38.07 |
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: BCBS Trust/PPO |
$34.94
|
| Rate for Payer: BCN Commercial |
$34.94
|
| Rate for Payer: Cash Price |
$33.84
|
| Rate for Payer: Cofinity Commercial |
$36.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.84
|
| Rate for Payer: Healthscope Commercial |
$38.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.95
|
| Rate for Payer: Nomi Health Commercial |
$34.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.73
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.22
|
| Rate for Payer: UHC Core |
$35.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.73
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
OP
|
$42.30
|
|
|
Service Code
|
NDC 68382011214
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.07 |
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.22
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$10.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.77
|
| Rate for Payer: BCN Commercial |
$34.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.57
|
| Rate for Payer: Cash Price |
$33.84
|
| Rate for Payer: Cofinity Commercial |
$36.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$38.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.73
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.10
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.95
|
| Rate for Payer: Nomi Health Commercial |
$34.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.73
|
| Rate for Payer: PACE Senior Care Partners |
$10.05
|
| Rate for Payer: PACE SWMI |
$10.57
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Medicare Advantage |
$10.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.80
|
| Rate for Payer: Priority Health Medicare |
$10.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.44
|
| Rate for Payer: Railroad Medicare Medicare |
$10.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.22
|
| Rate for Payer: UHC Core |
$35.32
|
| Rate for Payer: UHC Exchange |
$10.57
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.57
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.73
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$413.60
|
|
|
Service Code
|
NDC 00904736061
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.87 |
| Max. Negotiated Rate |
$372.24 |
| Rate for Payer: Aetna Commercial |
$351.56
|
| Rate for Payer: BCBS Trust/PPO |
$341.59
|
| Rate for Payer: BCN Commercial |
$341.59
|
| Rate for Payer: Cash Price |
$330.88
|
| Rate for Payer: Cofinity Commercial |
$355.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.88
|
| Rate for Payer: Healthscope Commercial |
$372.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.56
|
| Rate for Payer: Nomi Health Commercial |
$339.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.20
|
| Rate for Payer: PHP Commercial |
$351.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$359.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$345.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.20
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
OP
|
$4.61
|
|
|
Service Code
|
NDC 68084027011
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$4.15 |
| Rate for Payer: Aetna Commercial |
$3.92
|
| Rate for Payer: Aetna Medicare |
$1.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.44
|
| Rate for Payer: BCBS Complete |
$0.85
|
| Rate for Payer: BCBS MAPPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$3.79
|
| Rate for Payer: BCN Commercial |
$3.79
|
| Rate for Payer: BCN Medicare Advantage |
$1.15
|
| Rate for Payer: Cash Price |
$3.69
|
| Rate for Payer: Cofinity Commercial |
$3.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.15
|
| Rate for Payer: Healthscope Commercial |
$4.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.46
|
| Rate for Payer: Mclaren Medicaid |
$0.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.21
|
| Rate for Payer: Meridian Medicaid |
$0.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.92
|
| Rate for Payer: Nomi Health Commercial |
$3.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.46
|
| Rate for Payer: PACE Senior Care Partners |
$1.09
|
| Rate for Payer: PACE SWMI |
$1.15
|
| Rate for Payer: PHP Commercial |
$3.92
|
| Rate for Payer: PHP Medicare Advantage |
$1.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.01
|
| Rate for Payer: Priority Health Medicare |
$1.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.06
|
| Rate for Payer: UHC Core |
$3.85
|
| Rate for Payer: UHC Exchange |
$1.15
|
| Rate for Payer: UHC Medicaid |
$0.81
|
| Rate for Payer: UHC Medicare Advantage |
$1.15
|
| Rate for Payer: UHCCP Medicaid |
$0.81
|
| Rate for Payer: VA VA |
$1.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.46
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$1.34
|
|
|
Service Code
|
NDC 09900001854
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: Aetna Medicare |
$0.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.42
|
| Rate for Payer: BCBS Complete |
$0.25
|
| Rate for Payer: BCBS MAPPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$1.10
|
| Rate for Payer: BCN Commercial |
$1.10
|
| Rate for Payer: BCN Medicare Advantage |
$0.34
|
| Rate for Payer: Cash Price |
$1.07
|
| Rate for Payer: Cofinity Commercial |
$1.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.34
|
| Rate for Payer: Healthscope Commercial |
$1.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.00
|
| Rate for Payer: Mclaren Medicaid |
$0.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.14
|
| Rate for Payer: Nomi Health Commercial |
$1.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.00
|
| Rate for Payer: PACE Senior Care Partners |
$0.32
|
| Rate for Payer: PACE SWMI |
$0.34
|
| Rate for Payer: PHP Commercial |
$1.14
|
| Rate for Payer: PHP Medicare Advantage |
$0.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.17
|
| Rate for Payer: Priority Health Medicare |
$0.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.93
|
| Rate for Payer: Railroad Medicare Medicare |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.18
|
| Rate for Payer: UHC Core |
$1.12
|
| Rate for Payer: UHC Exchange |
$0.34
|
| Rate for Payer: UHC Medicaid |
$0.24
|
| Rate for Payer: UHC Medicare Advantage |
$0.34
|
| Rate for Payer: UHCCP Medicaid |
$0.24
|
| Rate for Payer: VA VA |
$0.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.00
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$2.68
|
|
|
Service Code
|
NDC 09900000348
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: Aetna Medicare |
$0.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.84
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS MAPPO |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$2.20
|
| Rate for Payer: BCN Commercial |
$2.20
|
| Rate for Payer: BCN Medicare Advantage |
$0.67
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.67
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.01
|
| 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 |
$0.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.64
|
| Rate for Payer: PACE SWMI |
$0.67
|
| Rate for Payer: PHP Commercial |
$2.28
|
| 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 |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$0.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.87
|
| Rate for Payer: Railroad Medicare Medicare |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.36
|
| Rate for Payer: UHC Core |
$2.24
|
| 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 |
$2.01
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$419.03
|
|
|
Service Code
|
NDC 50458059601
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.87 |
| Max. Negotiated Rate |
$377.13 |
| Rate for Payer: Aetna Commercial |
$356.18
|
| Rate for Payer: Aetna Medicare |
$108.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.95
|
| Rate for Payer: BCBS Complete |
$77.56
|
| Rate for Payer: BCBS MAPPO |
$104.76
|
| Rate for Payer: BCBS Trust/PPO |
$344.48
|
| Rate for Payer: BCN Commercial |
$344.48
|
| Rate for Payer: BCN Medicare Advantage |
$104.76
|
| Rate for Payer: Cash Price |
$335.22
|
| Rate for Payer: Cofinity Commercial |
$360.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.76
|
| Rate for Payer: Healthscope Commercial |
$377.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.27
|
| Rate for Payer: Mclaren Medicaid |
$73.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.00
|
| Rate for Payer: Meridian Medicaid |
$77.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.18
|
| Rate for Payer: Nomi Health Commercial |
$343.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.27
|
| Rate for Payer: PACE Senior Care Partners |
$99.52
|
| Rate for Payer: PACE SWMI |
$104.76
|
| Rate for Payer: PHP Commercial |
$356.18
|
| Rate for Payer: PHP Medicare Advantage |
$104.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$364.56
|
| Rate for Payer: Priority Health Medicare |
$105.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.64
|
| Rate for Payer: Railroad Medicare Medicare |
$104.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.75
|
| Rate for Payer: UHC Core |
$349.89
|
| Rate for Payer: UHC Exchange |
$104.76
|
| Rate for Payer: UHC Medicaid |
$73.87
|
| Rate for Payer: UHC Medicare Advantage |
$104.76
|
| Rate for Payer: UHCCP Medicaid |
$73.87
|
| Rate for Payer: VA VA |
$104.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.27
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$93.75
|
|
|
Service Code
|
NDC 65162067384
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.43
|
| Rate for Payer: BCN Commercial |
$77.43
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Nomi Health Commercial |
$76.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.50
|
| Rate for Payer: UHC Core |
$78.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$5.36
|
|
|
Service Code
|
NDC 09900000349
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$4.43
|
| Rate for Payer: BCN Commercial |
$4.43
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$4.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.02
|
| Rate for Payer: PHP Commercial |
$4.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Core |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.02
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$565.22
|
|
|
Service Code
|
NDC 50458030503
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$393.39 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$466.82
|
| Rate for Payer: BCN Commercial |
$466.82
|
| Rate for Payer: Cash Price |
$452.18
|
| Rate for Payer: Cofinity Commercial |
$486.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.18
|
| Rate for Payer: Healthscope Commercial |
$508.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.44
|
| Rate for Payer: Nomi Health Commercial |
$463.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.92
|
| Rate for Payer: PHP Commercial |
$480.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$393.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.39
|
| Rate for Payer: UHC Core |
$471.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$5.36
|
|
|
Service Code
|
NDC 09900000349
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.94 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: Aetna Medicare |
$1.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.68
|
| Rate for Payer: BCBS Complete |
$0.99
|
| Rate for Payer: BCBS MAPPO |
$1.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.41
|
| Rate for Payer: BCN Commercial |
$4.41
|
| Rate for Payer: BCN Medicare Advantage |
$1.34
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$4.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.02
|
| Rate for Payer: Mclaren Medicaid |
$0.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.41
|
| Rate for Payer: Meridian Medicaid |
$0.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.02
|
| Rate for Payer: PACE Senior Care Partners |
$1.27
|
| Rate for Payer: PACE SWMI |
$1.34
|
| Rate for Payer: PHP Commercial |
$4.56
|
| Rate for Payer: PHP Medicare Advantage |
$1.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Medicare |
$1.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Core |
$4.48
|
| Rate for Payer: UHC Exchange |
$1.34
|
| Rate for Payer: UHC Medicaid |
$0.94
|
| Rate for Payer: UHC Medicare Advantage |
$1.34
|
| Rate for Payer: UHCCP Medicaid |
$0.94
|
| Rate for Payer: VA VA |
$1.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.02
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$93.75
|
|
|
Service Code
|
NDC 65162067384
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: Aetna Medicare |
$24.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.30
|
| Rate for Payer: BCBS Complete |
$17.35
|
| Rate for Payer: BCBS MAPPO |
$23.44
|
| Rate for Payer: BCBS Trust/PPO |
$77.07
|
| Rate for Payer: BCN Commercial |
$77.07
|
| Rate for Payer: BCN Medicare Advantage |
$23.44
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.44
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: Mclaren Medicaid |
$16.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.61
|
| Rate for Payer: Meridian Medicaid |
$17.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Nomi Health Commercial |
$76.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.27
|
| Rate for Payer: PACE SWMI |
$23.44
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: PHP Medicare Advantage |
$23.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.56
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.25
|
| Rate for Payer: Railroad Medicare Medicare |
$23.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.50
|
| Rate for Payer: UHC Core |
$78.28
|
| Rate for Payer: UHC Exchange |
$23.44
|
| Rate for Payer: UHC Medicaid |
$16.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.44
|
| Rate for Payer: UHCCP Medicaid |
$16.53
|
| Rate for Payer: VA VA |
$23.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$2.68
|
|
|
Service Code
|
NDC 09900000348
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.21
|
| Rate for Payer: BCN Commercial |
$2.21
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PHP Commercial |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.36
|
| Rate for Payer: UHC Core |
$2.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.01
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$1.34
|
|
|
Service Code
|
NDC 09900001854
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: Cash Price |
$1.07
|
| Rate for Payer: Cofinity Commercial |
$1.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.07
|
| Rate for Payer: Healthscope Commercial |
$1.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.14
|
| Rate for Payer: Nomi Health Commercial |
$1.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.00
|
| Rate for Payer: PHP Commercial |
$1.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.18
|
| Rate for Payer: UHC Core |
$1.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.00
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$419.03
|
|
|
Service Code
|
NDC 50458059601
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$377.13 |
| Rate for Payer: Aetna Commercial |
$356.18
|
| Rate for Payer: BCBS Trust/PPO |
$346.08
|
| Rate for Payer: BCN Commercial |
$346.08
|
| Rate for Payer: Cash Price |
$335.22
|
| Rate for Payer: Cofinity Commercial |
$360.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.22
|
| Rate for Payer: Healthscope Commercial |
$377.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.18
|
| Rate for Payer: Nomi Health Commercial |
$343.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.27
|
| Rate for Payer: PHP Commercial |
$356.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$364.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.75
|
| Rate for Payer: UHC Core |
$349.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.27
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$565.22
|
|
|
Service Code
|
NDC 50458030503
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.65 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: Aetna Medicare |
$146.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.63
|
| Rate for Payer: BCBS Complete |
$104.62
|
| Rate for Payer: BCBS MAPPO |
$141.31
|
| Rate for Payer: BCBS Trust/PPO |
$464.67
|
| Rate for Payer: BCN Commercial |
$464.67
|
| Rate for Payer: BCN Medicare Advantage |
$141.31
|
| Rate for Payer: Cash Price |
$452.18
|
| Rate for Payer: Cofinity Commercial |
$486.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.31
|
| Rate for Payer: Healthscope Commercial |
$508.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.92
|
| Rate for Payer: Mclaren Medicaid |
$99.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.37
|
| Rate for Payer: Meridian Medicaid |
$104.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.44
|
| Rate for Payer: Nomi Health Commercial |
$463.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.92
|
| Rate for Payer: PACE Senior Care Partners |
$134.24
|
| Rate for Payer: PACE SWMI |
$141.31
|
| Rate for Payer: PHP Commercial |
$480.44
|
| Rate for Payer: PHP Medicare Advantage |
$141.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.74
|
| Rate for Payer: Priority Health Medicare |
$142.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$393.39
|
| Rate for Payer: Railroad Medicare Medicare |
$141.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.39
|
| Rate for Payer: UHC Core |
$471.96
|
| Rate for Payer: UHC Exchange |
$141.31
|
| Rate for Payer: UHC Medicaid |
$99.65
|
| Rate for Payer: UHC Medicare Advantage |
$141.31
|
| Rate for Payer: UHCCP Medicaid |
$99.65
|
| Rate for Payer: VA VA |
$141.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$1,684.98
|
|
|
Service Code
|
NDC 50458030001
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$297.06 |
| Max. Negotiated Rate |
$1,516.48 |
| Rate for Payer: Aetna Commercial |
$1,432.23
|
| Rate for Payer: Aetna Medicare |
$438.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$526.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$526.56
|
| Rate for Payer: BCBS Complete |
$311.89
|
| Rate for Payer: BCBS MAPPO |
$421.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,385.22
|
| Rate for Payer: BCN Commercial |
$1,385.22
|
| Rate for Payer: BCN Medicare Advantage |
$421.25
|
| Rate for Payer: Cash Price |
$1,347.98
|
| Rate for Payer: Cofinity Commercial |
$1,449.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,347.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.25
|
| Rate for Payer: Healthscope Commercial |
$1,516.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.73
|
| Rate for Payer: Mclaren Medicaid |
$297.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.31
|
| Rate for Payer: Meridian Medicaid |
$311.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.23
|
| Rate for Payer: Nomi Health Commercial |
$1,381.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.73
|
| Rate for Payer: PACE Senior Care Partners |
$400.18
|
| Rate for Payer: PACE SWMI |
$421.25
|
| Rate for Payer: PHP Commercial |
$1,432.23
|
| Rate for Payer: PHP Medicare Advantage |
$421.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,465.93
|
| Rate for Payer: Priority Health Medicare |
$425.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,172.75
|
| Rate for Payer: Railroad Medicare Medicare |
$421.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,482.78
|
| Rate for Payer: UHC Core |
$1,406.96
|
| Rate for Payer: UHC Exchange |
$421.25
|
| Rate for Payer: UHC Medicaid |
$297.06
|
| Rate for Payer: UHC Medicare Advantage |
$421.25
|
| Rate for Payer: UHCCP Medicaid |
$297.06
|
| Rate for Payer: VA VA |
$421.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.73
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$235.53 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: BCBS Trust/PPO |
$279.48
|
| Rate for Payer: BCN Commercial |
$279.48
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Nomi Health Commercial |
$277.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.79
|
| Rate for Payer: UHC Core |
$282.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$272.65
|
|
|
Service Code
|
NDC 00904736261
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna Medicare |
$70.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.20
|
| Rate for Payer: BCBS Complete |
$50.47
|
| Rate for Payer: BCBS MAPPO |
$68.16
|
| Rate for Payer: BCBS Trust/PPO |
$224.15
|
| Rate for Payer: BCN Commercial |
$224.15
|
| Rate for Payer: BCN Medicare Advantage |
$68.16
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.16
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: Mclaren Medicaid |
$48.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.57
|
| Rate for Payer: Meridian Medicaid |
$50.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Nomi Health Commercial |
$223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PACE Senior Care Partners |
$64.75
|
| Rate for Payer: PACE SWMI |
$68.16
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: PHP Medicare Advantage |
$68.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.21
|
| Rate for Payer: Priority Health Medicare |
$68.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.76
|
| Rate for Payer: Railroad Medicare Medicare |
$68.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.93
|
| Rate for Payer: UHC Core |
$227.66
|
| Rate for Payer: UHC Exchange |
$68.16
|
| Rate for Payer: UHC Medicaid |
$48.07
|
| Rate for Payer: UHC Medicare Advantage |
$68.16
|
| Rate for Payer: UHCCP Medicaid |
$48.07
|
| Rate for Payer: VA VA |
$68.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$1,684.98
|
|
|
Service Code
|
NDC 50458030001
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,172.75 |
| Max. Negotiated Rate |
$1,516.48 |
| Rate for Payer: Aetna Commercial |
$1,432.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,391.62
|
| Rate for Payer: BCN Commercial |
$1,391.62
|
| Rate for Payer: Cash Price |
$1,347.98
|
| Rate for Payer: Cofinity Commercial |
$1,449.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,347.98
|
| Rate for Payer: Healthscope Commercial |
$1,516.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.23
|
| Rate for Payer: Nomi Health Commercial |
$1,381.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,263.73
|
| Rate for Payer: PHP Commercial |
$1,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,465.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,172.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,482.78
|
| Rate for Payer: UHC Core |
$1,406.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.73
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.66 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna Medicare |
$87.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.75
|
| Rate for Payer: BCBS Complete |
$62.64
|
| Rate for Payer: BCBS MAPPO |
$84.60
|
| Rate for Payer: BCBS Trust/PPO |
$278.20
|
| Rate for Payer: BCN Commercial |
$278.20
|
| Rate for Payer: BCN Medicare Advantage |
$84.60
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Mclaren Medicaid |
$59.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.83
|
| Rate for Payer: Meridian Medicaid |
$62.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Nomi Health Commercial |
$277.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PACE Senior Care Partners |
$80.37
|
| Rate for Payer: PACE SWMI |
$84.60
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: PHP Medicare Advantage |
$84.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.41
|
| Rate for Payer: Priority Health Medicare |
$85.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.53
|
| Rate for Payer: Railroad Medicare Medicare |
$84.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.79
|
| Rate for Payer: UHC Core |
$282.56
|
| Rate for Payer: UHC Exchange |
$84.60
|
| Rate for Payer: UHC Medicaid |
$59.66
|
| Rate for Payer: UHC Medicare Advantage |
$84.60
|
| Rate for Payer: UHCCP Medicaid |
$59.66
|
| Rate for Payer: VA VA |
$84.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$272.65
|
|
|
Service Code
|
NDC 00904736261
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$189.76 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: BCBS Trust/PPO |
$225.18
|
| Rate for Payer: BCN Commercial |
$225.18
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.75
|
| Rate for Payer: Nomi Health Commercial |
$223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.49
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.93
|
| Rate for Payer: UHC Core |
$227.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
|
Facility
|
IP
|
$1,044.02
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
81838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$726.64 |
| Max. Negotiated Rate |
$939.62 |
| Rate for Payer: Aetna Commercial |
$887.42
|
| Rate for Payer: BCBS Trust/PPO |
$862.26
|
| Rate for Payer: BCN Commercial |
$862.26
|
| Rate for Payer: Cash Price |
$835.22
|
| Rate for Payer: Cofinity Commercial |
$897.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.22
|
| Rate for Payer: Healthscope Commercial |
$939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.42
|
| Rate for Payer: Nomi Health Commercial |
$856.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$783.01
|
| Rate for Payer: PHP Commercial |
$887.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$908.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.74
|
| Rate for Payer: UHC Core |
$871.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.01
|
|
|
RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
|
Facility
|
OP
|
$1,044.02
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
81838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$184.06 |
| Max. Negotiated Rate |
$939.62 |
| Rate for Payer: Aetna Commercial |
$887.42
|
| Rate for Payer: Aetna Medicare |
$271.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.26
|
| Rate for Payer: BCBS Complete |
$193.25
|
| Rate for Payer: BCBS MAPPO |
$261.00
|
| Rate for Payer: BCBS Trust/PPO |
$858.29
|
| Rate for Payer: BCN Commercial |
$858.29
|
| Rate for Payer: BCN Medicare Advantage |
$261.00
|
| Rate for Payer: Cash Price |
$835.22
|
| Rate for Payer: Cofinity Commercial |
$897.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.00
|
| Rate for Payer: Healthscope Commercial |
$939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.01
|
| Rate for Payer: Mclaren Medicaid |
$184.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$274.06
|
| Rate for Payer: Meridian Medicaid |
$193.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$287.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.42
|
| Rate for Payer: Nomi Health Commercial |
$856.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$783.01
|
| Rate for Payer: PACE Senior Care Partners |
$247.95
|
| Rate for Payer: PACE SWMI |
$261.00
|
| Rate for Payer: PHP Commercial |
$887.42
|
| Rate for Payer: PHP Medicare Advantage |
$261.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$908.30
|
| Rate for Payer: Priority Health Medicare |
$263.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.64
|
| Rate for Payer: Railroad Medicare Medicare |
$261.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.74
|
| Rate for Payer: UHC Core |
$871.76
|
| Rate for Payer: UHC Exchange |
$261.00
|
| Rate for Payer: UHC Medicaid |
$184.06
|
| Rate for Payer: UHC Medicare Advantage |
$261.00
|
| Rate for Payer: UHCCP Medicaid |
$184.06
|
| Rate for Payer: VA VA |
$261.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.01
|
|
|
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
OP
|
$1,881.96
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$331.79 |
| Max. Negotiated Rate |
$1,693.76 |
| Rate for Payer: Aetna Commercial |
$1,599.67
|
| Rate for Payer: Aetna Medicare |
$489.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$588.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$588.11
|
| Rate for Payer: BCBS Complete |
$348.35
|
| Rate for Payer: BCBS MAPPO |
$470.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,547.16
|
| Rate for Payer: BCN Commercial |
$1,547.16
|
| Rate for Payer: BCN Medicare Advantage |
$470.49
|
| Rate for Payer: Cash Price |
$1,505.57
|
| Rate for Payer: Cofinity Commercial |
$1,618.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.49
|
| Rate for Payer: Healthscope Commercial |
$1,693.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.47
|
| Rate for Payer: Mclaren Medicaid |
$331.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.01
|
| Rate for Payer: Meridian Medicaid |
$348.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$541.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.67
|
| Rate for Payer: Nomi Health Commercial |
$1,543.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,411.47
|
| Rate for Payer: PACE Senior Care Partners |
$446.97
|
| Rate for Payer: PACE SWMI |
$470.49
|
| Rate for Payer: PHP Commercial |
$1,599.67
|
| Rate for Payer: PHP Medicare Advantage |
$470.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,637.31
|
| Rate for Payer: Priority Health Medicare |
$475.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,309.84
|
| Rate for Payer: Railroad Medicare Medicare |
$470.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,656.12
|
| Rate for Payer: UHC Core |
$1,571.44
|
| Rate for Payer: UHC Exchange |
$470.49
|
| Rate for Payer: UHC Medicaid |
$331.79
|
| Rate for Payer: UHC Medicare Advantage |
$470.49
|
| Rate for Payer: UHCCP Medicaid |
$331.79
|
| Rate for Payer: VA VA |
$470.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.47
|
|
