|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.94
|
|
|
Service Code
|
NDC 72611075601
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$26.05 |
| Rate for Payer: Aetna Commercial |
$24.60
|
| Rate for Payer: Aetna Medicare |
$7.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.04
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.24
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$24.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.24
|
| Rate for Payer: Healthscope Commercial |
$26.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.70
|
| Rate for Payer: Mclaren Medicaid |
$5.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.60
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$23.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.70
|
| Rate for Payer: PACE Senior Care Partners |
$6.87
|
| Rate for Payer: PACE SWMI |
$7.24
|
| Rate for Payer: PHP Commercial |
$24.60
|
| Rate for Payer: PHP Medicare Advantage |
$7.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.18
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.47
|
| Rate for Payer: UHC Core |
$24.16
|
| Rate for Payer: UHC Exchange |
$7.24
|
| Rate for Payer: UHC Medicaid |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.24
|
| Rate for Payer: UHCCP Medicaid |
$5.10
|
| Rate for Payer: VA VA |
$7.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.70
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.31
|
|
|
Service Code
|
NDC 47781061620
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: Aetna Medicare |
$6.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.91
|
| Rate for Payer: BCBS Complete |
$4.68
|
| Rate for Payer: BCBS MAPPO |
$6.33
|
| Rate for Payer: BCBS Trust/PPO |
$20.81
|
| Rate for Payer: BCN Commercial |
$20.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.33
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.33
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.98
|
| Rate for Payer: Mclaren Medicaid |
$4.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.64
|
| Rate for Payer: Meridian Medicaid |
$4.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Nomi Health Commercial |
$20.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.98
|
| Rate for Payer: PACE Senior Care Partners |
$6.01
|
| Rate for Payer: PACE SWMI |
$6.33
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.02
|
| Rate for Payer: Priority Health Medicare |
$6.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.27
|
| Rate for Payer: UHC Core |
$21.13
|
| Rate for Payer: UHC Exchange |
$6.33
|
| Rate for Payer: UHC Medicaid |
$4.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.33
|
| Rate for Payer: UHCCP Medicaid |
$4.46
|
| Rate for Payer: VA VA |
$6.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.98
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.64
|
|
|
Service Code
|
NDC 00143925010
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$21.28 |
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: BCBS Trust/PPO |
$19.52
|
| Rate for Payer: BCN Commercial |
$19.52
|
| Rate for Payer: Cash Price |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$20.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.91
|
| Rate for Payer: Healthscope Commercial |
$21.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.73
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.80
|
| Rate for Payer: UHC Core |
$19.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.73
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.49
|
|
|
Service Code
|
NDC 00409318910
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$6.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.34
|
| Rate for Payer: BCBS Complete |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$5.87
|
| Rate for Payer: BCBS Trust/PPO |
$19.31
|
| Rate for Payer: BCN Commercial |
$19.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.87
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.87
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Mclaren Medicaid |
$4.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.17
|
| Rate for Payer: Meridian Medicaid |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.58
|
| Rate for Payer: PACE SWMI |
$5.87
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Medicare |
$5.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: UHC Exchange |
$5.87
|
| Rate for Payer: UHC Medicaid |
$4.14
|
| Rate for Payer: UHC Medicare Advantage |
$5.87
|
| Rate for Payer: UHCCP Medicaid |
$4.14
|
| Rate for Payer: VA VA |
$5.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 39822420002
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.77 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.49
|
|
|
Service Code
|
NDC 00409140305
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$6.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.34
|
| Rate for Payer: BCBS Complete |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$5.87
|
| Rate for Payer: BCBS Trust/PPO |
$19.31
|
| Rate for Payer: BCN Commercial |
$19.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.87
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.87
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Mclaren Medicaid |
$4.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.17
|
| Rate for Payer: Meridian Medicaid |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.58
|
| Rate for Payer: PACE SWMI |
$5.87
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Medicare |
$5.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: UHC Exchange |
$5.87
|
| Rate for Payer: UHC Medicaid |
$4.14
|
| Rate for Payer: UHC Medicare Advantage |
$5.87
|
| Rate for Payer: UHCCP Medicaid |
$4.14
|
| Rate for Payer: VA VA |
$5.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
NDC 00409955849
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$20.87
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$4.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.04
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicaid |
$4.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$4.48
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.31
|
|
|
Service Code
|
NDC 47781061620
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.62 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$20.90
|
| Rate for Payer: BCN Commercial |
$20.90
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Nomi Health Commercial |
$20.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.98
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.27
|
| Rate for Payer: UHC Core |
$21.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.98
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
NDC 00409955849
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.67 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.97
|
| Rate for Payer: BCN Commercial |
$20.97
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.04
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.94
|
|
|
Service Code
|
NDC 72611075610
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$26.05 |
| Rate for Payer: Aetna Commercial |
$24.60
|
| Rate for Payer: BCBS Trust/PPO |
$23.90
|
| Rate for Payer: BCN Commercial |
$23.90
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$24.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.15
|
| Rate for Payer: Healthscope Commercial |
$26.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$23.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.70
|
| Rate for Payer: PHP Commercial |
$24.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.47
|
| Rate for Payer: UHC Core |
$24.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.70
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.64
|
|
|
Service Code
|
NDC 00143925001
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$21.28 |
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: BCBS Trust/PPO |
$19.52
|
| Rate for Payer: BCN Commercial |
$19.52
|
| Rate for Payer: Cash Price |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$20.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.91
|
| Rate for Payer: Healthscope Commercial |
$21.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.73
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.80
|
| Rate for Payer: UHC Core |
$19.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.73
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.35
|
|
|
Service Code
|
NDC 43066000710
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$25.52 |
| Rate for Payer: Aetna Commercial |
$24.10
|
| Rate for Payer: Aetna Medicare |
$7.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.86
|
| Rate for Payer: BCBS Complete |
$5.25
|
| Rate for Payer: BCBS MAPPO |
$7.09
|
| Rate for Payer: BCBS Trust/PPO |
$23.31
|
| Rate for Payer: BCN Commercial |
$23.31
|
| Rate for Payer: BCN Medicare Advantage |
$7.09
|
| Rate for Payer: Cash Price |
$22.68
|
| Rate for Payer: Cofinity Commercial |
$24.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.09
|
| Rate for Payer: Healthscope Commercial |
$25.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.26
|
| Rate for Payer: Mclaren Medicaid |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.44
|
| Rate for Payer: Meridian Medicaid |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.10
|
| Rate for Payer: Nomi Health Commercial |
$23.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.26
|
| Rate for Payer: PACE Senior Care Partners |
$6.73
|
| Rate for Payer: PACE SWMI |
$7.09
|
| Rate for Payer: PHP Commercial |
$24.10
|
| Rate for Payer: PHP Medicare Advantage |
$7.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.66
|
| Rate for Payer: Priority Health Medicare |
$7.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.73
|
| Rate for Payer: Railroad Medicare Medicare |
$7.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.95
|
| Rate for Payer: UHC Core |
$23.67
|
| Rate for Payer: UHC Exchange |
$7.09
|
| Rate for Payer: UHC Medicaid |
$5.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.09
|
| Rate for Payer: UHCCP Medicaid |
$5.00
|
| Rate for Payer: VA VA |
$7.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.26
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.49
|
|
|
Service Code
|
NDC 00409140310
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$6.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.34
|
| Rate for Payer: BCBS Complete |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$5.87
|
| Rate for Payer: BCBS Trust/PPO |
$19.31
|
| Rate for Payer: BCN Commercial |
$19.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.87
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.87
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Mclaren Medicaid |
$4.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.17
|
| Rate for Payer: Meridian Medicaid |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.58
|
| Rate for Payer: PACE SWMI |
$5.87
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Medicare |
$5.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: UHC Exchange |
$5.87
|
| Rate for Payer: UHC Medicaid |
$4.14
|
| Rate for Payer: UHC Medicare Advantage |
$5.87
|
| Rate for Payer: UHCCP Medicaid |
$4.14
|
| Rate for Payer: VA VA |
$5.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.94
|
|
|
Service Code
|
NDC 72611075601
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$26.05 |
| Rate for Payer: Aetna Commercial |
$24.60
|
| Rate for Payer: BCBS Trust/PPO |
$23.90
|
| Rate for Payer: BCN Commercial |
$23.90
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$24.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.15
|
| Rate for Payer: Healthscope Commercial |
$26.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$23.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.70
|
| Rate for Payer: PHP Commercial |
$24.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.47
|
| Rate for Payer: UHC Core |
$24.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.70
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.49
|
|
|
Service Code
|
NDC 00409140305
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.35 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: BCBS Trust/PPO |
$19.40
|
| Rate for Payer: BCN Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.49
|
|
|
Service Code
|
NDC 00409140310
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.35 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: BCBS Trust/PPO |
$19.40
|
| Rate for Payer: BCN Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.09
|
|
|
Service Code
|
NDC 39822420002
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.53
|
| Rate for Payer: BCBS Complete |
$4.46
|
| Rate for Payer: BCBS MAPPO |
$6.02
|
| Rate for Payer: BCBS Trust/PPO |
$19.80
|
| Rate for Payer: BCN Commercial |
$19.80
|
| Rate for Payer: BCN Medicare Advantage |
$6.02
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.02
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Mclaren Medicaid |
$4.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$4.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.72
|
| Rate for Payer: PACE SWMI |
$6.02
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Medicare Advantage |
$6.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Medicare |
$6.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.77
|
| Rate for Payer: Railroad Medicare Medicare |
$6.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Exchange |
$6.02
|
| Rate for Payer: UHC Medicaid |
$4.25
|
| Rate for Payer: UHC Medicare Advantage |
$6.02
|
| Rate for Payer: UHCCP Medicaid |
$4.25
|
| Rate for Payer: VA VA |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.49
|
|
|
Service Code
|
NDC 00409318905
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.35 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: BCBS Trust/PPO |
$19.40
|
| Rate for Payer: BCN Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.67
|
|
|
Service Code
|
NDC 67457022805
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: BCBS Trust/PPO |
$16.25
|
| Rate for Payer: BCN Commercial |
$16.25
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$16.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Healthscope Commercial |
$17.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$16.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.75
|
| Rate for Payer: PHP Commercial |
$16.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.31
|
| Rate for Payer: UHC Core |
$16.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.75
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.94
|
|
|
Service Code
|
NDC 72611075610
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$26.05 |
| Rate for Payer: Aetna Commercial |
$24.60
|
| Rate for Payer: Aetna Medicare |
$7.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.04
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.24
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$24.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.24
|
| Rate for Payer: Healthscope Commercial |
$26.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.70
|
| Rate for Payer: Mclaren Medicaid |
$5.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.60
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$23.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.70
|
| Rate for Payer: PACE Senior Care Partners |
$6.87
|
| Rate for Payer: PACE SWMI |
$7.24
|
| Rate for Payer: PHP Commercial |
$24.60
|
| Rate for Payer: PHP Medicare Advantage |
$7.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.18
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.47
|
| Rate for Payer: UHC Core |
$24.16
|
| Rate for Payer: UHC Exchange |
$7.24
|
| Rate for Payer: UHC Medicaid |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.24
|
| Rate for Payer: UHCCP Medicaid |
$5.10
|
| Rate for Payer: VA VA |
$7.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.70
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 25021066205
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.77 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.12
|
|
|
Service Code
|
NDC 00409955805
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$17.21 |
| Rate for Payer: Aetna Commercial |
$16.25
|
| Rate for Payer: BCBS Trust/PPO |
$15.79
|
| Rate for Payer: BCN Commercial |
$15.79
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cofinity Commercial |
$16.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$17.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.25
|
| Rate for Payer: Nomi Health Commercial |
$15.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.34
|
| Rate for Payer: PHP Commercial |
$16.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.83
|
| Rate for Payer: UHC Core |
$15.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.34
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.49
|
|
|
Service Code
|
NDC 00409318910
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.35 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: BCBS Trust/PPO |
$19.40
|
| Rate for Payer: BCN Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Nomi Health Commercial |
$19.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.67
|
| Rate for Payer: UHC Core |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.64
|
|
|
Service Code
|
NDC 00143925010
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.17 |
| Max. Negotiated Rate |
$21.28 |
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: Aetna Medicare |
$6.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.39
|
| Rate for Payer: BCBS Complete |
$4.38
|
| Rate for Payer: BCBS MAPPO |
$5.91
|
| Rate for Payer: BCBS Trust/PPO |
$19.43
|
| Rate for Payer: BCN Commercial |
$19.43
|
| Rate for Payer: BCN Medicare Advantage |
$5.91
|
| Rate for Payer: Cash Price |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$20.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.91
|
| Rate for Payer: Healthscope Commercial |
$21.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.73
|
| Rate for Payer: Mclaren Medicaid |
$4.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.21
|
| Rate for Payer: Meridian Medicaid |
$4.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.73
|
| Rate for Payer: PACE Senior Care Partners |
$5.61
|
| Rate for Payer: PACE SWMI |
$5.91
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Medicare Advantage |
$5.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.57
|
| Rate for Payer: Priority Health Medicare |
$5.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.80
|
| Rate for Payer: UHC Core |
$19.74
|
| Rate for Payer: UHC Exchange |
$5.91
|
| Rate for Payer: UHC Medicaid |
$4.17
|
| Rate for Payer: UHC Medicare Advantage |
$5.91
|
| Rate for Payer: UHCCP Medicaid |
$4.17
|
| Rate for Payer: VA VA |
$5.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.73
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.31
|
|
|
Service Code
|
NDC 47781061617
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: Aetna Medicare |
$6.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.91
|
| Rate for Payer: BCBS Complete |
$4.68
|
| Rate for Payer: BCBS MAPPO |
$6.33
|
| Rate for Payer: BCBS Trust/PPO |
$20.81
|
| Rate for Payer: BCN Commercial |
$20.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.33
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.33
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.98
|
| Rate for Payer: Mclaren Medicaid |
$4.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.64
|
| Rate for Payer: Meridian Medicaid |
$4.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Nomi Health Commercial |
$20.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.98
|
| Rate for Payer: PACE Senior Care Partners |
$6.01
|
| Rate for Payer: PACE SWMI |
$6.33
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.02
|
| Rate for Payer: Priority Health Medicare |
$6.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.27
|
| Rate for Payer: UHC Core |
$21.13
|
| Rate for Payer: UHC Exchange |
$6.33
|
| Rate for Payer: UHC Medicaid |
$4.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.33
|
| Rate for Payer: UHCCP Medicaid |
$4.46
|
| Rate for Payer: VA VA |
$6.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.98
|
|
