|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
OP
|
$198.55
|
|
|
Service Code
|
NDC 68084027001
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.16 |
| Max. Negotiated Rate |
$178.69 |
| Rate for Payer: Aetna Commercial |
$168.77
|
| Rate for Payer: Aetna Medicare |
$51.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.05
|
| Rate for Payer: BCBS Complete |
$79.42
|
| Rate for Payer: BCBS MAPPO |
$49.64
|
| Rate for Payer: BCBS Trust/PPO |
$163.23
|
| Rate for Payer: BCN Commercial |
$154.37
|
| Rate for Payer: BCN Medicare Advantage |
$49.64
|
| Rate for Payer: Cash Price |
$158.84
|
| Rate for Payer: Cofinity Commercial |
$170.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.64
|
| Rate for Payer: Healthscope Commercial |
$178.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.77
|
| Rate for Payer: Nomi Health Commercial |
$162.81
|
| Rate for Payer: PACE Senior Care Partners |
$47.16
|
| Rate for Payer: PACE SWMI |
$49.64
|
| Rate for Payer: PHP Commercial |
$168.77
|
| Rate for Payer: PHP Medicare Advantage |
$49.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.06
|
| Rate for Payer: Priority Health HMO/PPO |
$172.74
|
| Rate for Payer: Priority Health Medicare |
$50.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.03
|
| Rate for Payer: Railroad Medicare Medicare |
$49.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.72
|
| Rate for Payer: UHC Core |
$165.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.64
|
| Rate for Payer: UHC Exchange |
$49.64
|
| Rate for Payer: UHC Medicare Advantage |
$49.64
|
| Rate for Payer: VA VA |
$49.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.91
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
OP
|
$310.20
|
|
|
Service Code
|
NDC 00904635761
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.67 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna Medicare |
$80.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.94
|
| Rate for Payer: BCBS Complete |
$124.08
|
| Rate for Payer: BCBS MAPPO |
$77.55
|
| Rate for Payer: BCBS Trust/PPO |
$255.02
|
| Rate for Payer: BCN Commercial |
$241.18
|
| Rate for Payer: BCN Medicare Advantage |
$77.55
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.55
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: Nomi Health Commercial |
$254.36
|
| Rate for Payer: PACE Senior Care Partners |
$73.67
|
| Rate for Payer: PACE SWMI |
$77.55
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: PHP Medicare Advantage |
$77.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health HMO/PPO |
$269.87
|
| Rate for Payer: Priority Health Medicare |
$78.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.83
|
| Rate for Payer: Railroad Medicare Medicare |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.98
|
| Rate for Payer: UHC Core |
$259.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.55
|
| Rate for Payer: UHC Exchange |
$77.55
|
| Rate for Payer: UHC Medicare Advantage |
$77.55
|
| Rate for Payer: VA VA |
$77.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
OP
|
$1.99
|
|
|
Service Code
|
NDC 68084027011
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$1.79 |
| Rate for Payer: Aetna Commercial |
$1.69
|
| Rate for Payer: Aetna Medicare |
$0.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.62
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.64
|
| Rate for Payer: BCN Commercial |
$1.55
|
| Rate for Payer: BCN Medicare Advantage |
$0.50
|
| Rate for Payer: Cash Price |
$1.59
|
| Rate for Payer: Cofinity Commercial |
$1.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.50
|
| Rate for Payer: Healthscope Commercial |
$1.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.69
|
| Rate for Payer: Nomi Health Commercial |
$1.63
|
| Rate for Payer: PACE Senior Care Partners |
$0.47
|
| Rate for Payer: PACE SWMI |
$0.50
|
| Rate for Payer: PHP Commercial |
$1.69
|
| Rate for Payer: PHP Medicare Advantage |
$0.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.29
|
| Rate for Payer: Priority Health HMO/PPO |
$1.73
|
| Rate for Payer: Priority Health Medicare |
$0.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.75
|
| Rate for Payer: UHC Core |
$1.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.50
|
| Rate for Payer: UHC Exchange |
$0.50
|
| Rate for Payer: UHC Medicare Advantage |
$0.50
|
| Rate for Payer: VA VA |
$0.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.49
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 00904635761
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$201.63 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: BCBS Trust/PPO |
$253.22
|
| Rate for Payer: BCN Commercial |
$239.72
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: Nomi Health Commercial |
$254.36
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health HMO/PPO |
$269.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.98
|
| Rate for Payer: UHC Core |
$259.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$198.55
|
|
|
Service Code
|
NDC 68084027001
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.06 |
| Max. Negotiated Rate |
$178.69 |
| Rate for Payer: Aetna Commercial |
$168.77
|
| Rate for Payer: BCBS Trust/PPO |
$162.08
|
| Rate for Payer: BCN Commercial |
$153.44
|
| Rate for Payer: Cash Price |
$158.84
|
| Rate for Payer: Cofinity Commercial |
$170.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.84
|
| Rate for Payer: Healthscope Commercial |
$178.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.77
|
| Rate for Payer: Nomi Health Commercial |
$162.81
|
| Rate for Payer: PHP Commercial |
$168.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.06
|
| Rate for Payer: Priority Health HMO/PPO |
$172.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.72
|
| Rate for Payer: UHC Core |
$165.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.91
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$1.99
|
|
|
Service Code
|
NDC 68084027011
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.79 |
| Rate for Payer: Aetna Commercial |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.62
|
| Rate for Payer: BCN Commercial |
$1.54
|
| Rate for Payer: Cash Price |
$1.59
|
| Rate for Payer: Cofinity Commercial |
$1.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.59
|
| Rate for Payer: Healthscope Commercial |
$1.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.69
|
| Rate for Payer: Nomi Health Commercial |
$1.63
|
| Rate for Payer: PHP Commercial |
$1.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.29
|
| Rate for Payer: Priority Health HMO/PPO |
$1.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.75
|
| Rate for Payer: UHC Core |
$1.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.49
|
|
|
RISPERIDONE 0.5 MG TABLET
|
Facility
|
IP
|
$399.50
|
|
|
Service Code
|
NDC 00904635861
|
| Hospital Charge Code |
25520
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$359.55 |
| Rate for Payer: Aetna Commercial |
$339.57
|
| Rate for Payer: BCBS Trust/PPO |
$326.11
|
| Rate for Payer: BCN Commercial |
$308.73
|
| Rate for Payer: Cash Price |
$319.60
|
| Rate for Payer: Cofinity Commercial |
$343.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.60
|
| Rate for Payer: Healthscope Commercial |
$359.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.57
|
| Rate for Payer: Nomi Health Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$339.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.68
|
| Rate for Payer: Priority Health HMO/PPO |
$347.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.56
|
| Rate for Payer: UHC Core |
$333.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.62
|
|
|
RISPERIDONE 0.5 MG TABLET
|
Facility
|
OP
|
$399.50
|
|
|
Service Code
|
NDC 00904635861
|
| Hospital Charge Code |
25520
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.88 |
| Max. Negotiated Rate |
$359.55 |
| Rate for Payer: Aetna Commercial |
$339.57
|
| Rate for Payer: Aetna Medicare |
$103.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.84
|
| Rate for Payer: BCBS Complete |
$159.80
|
| Rate for Payer: BCBS MAPPO |
$99.88
|
| Rate for Payer: BCBS Trust/PPO |
$328.43
|
| Rate for Payer: BCN Commercial |
$310.61
|
| Rate for Payer: BCN Medicare Advantage |
$99.88
|
| Rate for Payer: Cash Price |
$319.60
|
| Rate for Payer: Cofinity Commercial |
$343.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$359.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.57
|
| Rate for Payer: Nomi Health Commercial |
$327.59
|
| Rate for Payer: PACE Senior Care Partners |
$94.88
|
| Rate for Payer: PACE SWMI |
$99.88
|
| Rate for Payer: PHP Commercial |
$339.57
|
| Rate for Payer: PHP Medicare Advantage |
$99.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.68
|
| Rate for Payer: Priority Health HMO/PPO |
$347.56
|
| Rate for Payer: Priority Health Medicare |
$100.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.67
|
| Rate for Payer: Railroad Medicare Medicare |
$99.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.56
|
| Rate for Payer: UHC Core |
$333.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.88
|
| Rate for Payer: UHC Exchange |
$99.88
|
| Rate for Payer: UHC Medicare Advantage |
$99.88
|
| Rate for Payer: VA VA |
$99.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.62
|
|
|
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 |
$3.48 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$4.38
|
| Rate for Payer: BCN Commercial |
$4.14
|
| 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: PHP Commercial |
$4.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.59
|
| 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
|
OP
|
$5.36
|
|
|
Service Code
|
NDC 09900000349
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.27 |
| 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 |
$2.14
|
| Rate for Payer: BCBS MAPPO |
$1.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.41
|
| Rate for Payer: BCN Commercial |
$4.17
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| 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 Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Medicare |
$1.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.59
|
| 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 Dual Complete DSNP |
$1.34
|
| Rate for Payer: UHC Exchange |
$1.34
|
| Rate for Payer: UHC Medicare Advantage |
$1.34
|
| 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
|
IP
|
$1.34
|
|
|
Service Code
|
NDC 09900001854
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: BCBS Trust/PPO |
$1.09
|
| Rate for Payer: BCN Commercial |
$1.04
|
| 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: PHP Commercial |
$1.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.90
|
| 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
|
OP
|
$1.34
|
|
|
Service Code
|
NDC 09900001854
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.32 |
| 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 |
$0.54
|
| Rate for Payer: BCBS MAPPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$1.10
|
| Rate for Payer: BCN Commercial |
$1.04
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.14
|
| Rate for Payer: Nomi Health Commercial |
$1.10
|
| 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 Cigna Priority Health |
$0.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1.17
|
| Rate for Payer: Priority Health Medicare |
$0.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.90
|
| 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 Dual Complete DSNP |
$0.34
|
| Rate for Payer: UHC Exchange |
$0.34
|
| Rate for Payer: UHC Medicare Advantage |
$0.34
|
| 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
|
IP
|
$565.22
|
|
|
Service Code
|
NDC 50458030503
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$367.39 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$461.39
|
| Rate for Payer: BCN Commercial |
$436.80
|
| 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: PHP Commercial |
$480.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.39
|
| Rate for Payer: Priority Health HMO/PPO |
$491.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$378.70
|
| 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
|
IP
|
$2.68
|
|
|
Service Code
|
NDC 09900000348
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.19
|
| Rate for Payer: BCN Commercial |
$2.07
|
| 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: PHP Commercial |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.80
|
| 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
|
OP
|
$93.75
|
|
|
Service Code
|
NDC 65162067384
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.27 |
| 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 |
$37.50
|
| Rate for Payer: BCBS MAPPO |
$23.44
|
| Rate for Payer: BCBS Trust/PPO |
$77.07
|
| Rate for Payer: BCN Commercial |
$72.89
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Nomi Health Commercial |
$76.88
|
| 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 Cigna Priority Health |
$60.94
|
| Rate for Payer: Priority Health HMO/PPO |
$81.56
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.81
|
| 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 Dual Complete DSNP |
$23.44
|
| Rate for Payer: UHC Exchange |
$23.44
|
| Rate for Payer: UHC Medicare Advantage |
$23.44
|
| 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
|
$74.45
|
|
|
Service Code
|
NDC 50458059601
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.39 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: BCBS Trust/PPO |
$60.77
|
| Rate for Payer: BCN Commercial |
$57.53
|
| Rate for Payer: Cash Price |
$59.56
|
| Rate for Payer: Cofinity Commercial |
$64.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.56
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.28
|
| Rate for Payer: Nomi Health Commercial |
$61.05
|
| Rate for Payer: PHP Commercial |
$63.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.39
|
| Rate for Payer: Priority Health HMO/PPO |
$64.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
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 |
$134.24 |
| 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 |
$226.09
|
| Rate for Payer: BCBS MAPPO |
$141.31
|
| Rate for Payer: BCBS Trust/PPO |
$464.67
|
| Rate for Payer: BCN Commercial |
$439.46
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.44
|
| Rate for Payer: Nomi Health Commercial |
$463.48
|
| 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 Cigna Priority Health |
$367.39
|
| Rate for Payer: Priority Health HMO/PPO |
$491.74
|
| Rate for Payer: Priority Health Medicare |
$142.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$378.70
|
| 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 Dual Complete DSNP |
$141.31
|
| Rate for Payer: UHC Exchange |
$141.31
|
| Rate for Payer: UHC Medicare Advantage |
$141.31
|
| Rate for Payer: VA VA |
$141.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
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 |
$0.64 |
| 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 |
$1.07
|
| Rate for Payer: BCBS MAPPO |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$2.20
|
| Rate for Payer: BCN Commercial |
$2.08
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.20
|
| 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 Cigna Priority Health |
$1.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$0.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.80
|
| 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 Dual Complete DSNP |
$0.67
|
| Rate for Payer: UHC Exchange |
$0.67
|
| Rate for Payer: UHC Medicare Advantage |
$0.67
|
| 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
|
$74.45
|
|
|
Service Code
|
NDC 50458059601
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$29.78
|
| Rate for Payer: BCBS MAPPO |
$18.61
|
| Rate for Payer: BCBS Trust/PPO |
$61.21
|
| Rate for Payer: BCN Commercial |
$57.88
|
| Rate for Payer: BCN Medicare Advantage |
$18.61
|
| Rate for Payer: Cash Price |
$59.56
|
| Rate for Payer: Cofinity Commercial |
$64.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.28
|
| Rate for Payer: Nomi Health Commercial |
$61.05
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.61
|
| Rate for Payer: PHP Commercial |
$63.28
|
| Rate for Payer: PHP Medicare Advantage |
$18.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.39
|
| Rate for Payer: Priority Health HMO/PPO |
$64.77
|
| Rate for Payer: Priority Health Medicare |
$18.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.88
|
| Rate for Payer: Railroad Medicare Medicare |
$18.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.61
|
| Rate for Payer: UHC Exchange |
$18.61
|
| Rate for Payer: UHC Medicare Advantage |
$18.61
|
| Rate for Payer: VA VA |
$18.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
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 |
$60.94 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: BCBS Trust/PPO |
$76.53
|
| Rate for Payer: BCN Commercial |
$72.45
|
| 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: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.94
|
| Rate for Payer: Priority Health HMO/PPO |
$81.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.81
|
| 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 TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$219.96 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: BCBS Trust/PPO |
$276.24
|
| Rate for Payer: BCN Commercial |
$261.52
|
| 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: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.96
|
| Rate for Payer: Priority Health HMO/PPO |
$294.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.73
|
| 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
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.37 |
| 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 |
$135.36
|
| Rate for Payer: BCBS MAPPO |
$84.60
|
| Rate for Payer: BCBS Trust/PPO |
$278.20
|
| Rate for Payer: BCN Commercial |
$263.11
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Nomi Health Commercial |
$277.49
|
| 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 Cigna Priority Health |
$219.96
|
| Rate for Payer: Priority Health HMO/PPO |
$294.41
|
| Rate for Payer: Priority Health Medicare |
$85.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.73
|
| 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 Dual Complete DSNP |
$84.60
|
| Rate for Payer: UHC Exchange |
$84.60
|
| Rate for Payer: UHC Medicare Advantage |
$84.60
|
| Rate for Payer: VA VA |
$84.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$1,684.98
|
|
|
Service Code
|
NDC 50458030001
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,095.24 |
| Max. Negotiated Rate |
$1,516.48 |
| Rate for Payer: Aetna Commercial |
$1,432.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,375.45
|
| Rate for Payer: BCN Commercial |
$1,302.15
|
| 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: PHP Commercial |
$1,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.24
|
| Rate for Payer: Priority Health HMO/PPO |
$1,465.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,128.94
|
| 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
|
$1,684.98
|
|
|
Service Code
|
NDC 50458030001
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$400.18 |
| 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 |
$673.99
|
| Rate for Payer: BCBS MAPPO |
$421.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,385.22
|
| Rate for Payer: BCN Commercial |
$1,310.07
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.23
|
| Rate for Payer: Nomi Health Commercial |
$1,381.68
|
| 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 Cigna Priority Health |
$1,095.24
|
| Rate for Payer: Priority Health HMO/PPO |
$1,465.93
|
| Rate for Payer: Priority Health Medicare |
$425.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,128.94
|
| 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 Dual Complete DSNP |
$421.25
|
| Rate for Payer: UHC Exchange |
$421.25
|
| Rate for Payer: UHC Medicare Advantage |
$421.25
|
| Rate for Payer: VA VA |
$421.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.73
|
|
|
RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
|
Facility
|
IP
|
$994.29
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
81838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$646.29 |
| Max. Negotiated Rate |
$894.86 |
| Rate for Payer: Aetna Commercial |
$845.15
|
| Rate for Payer: BCBS Trust/PPO |
$811.64
|
| Rate for Payer: BCN Commercial |
$768.39
|
| Rate for Payer: Cash Price |
$795.43
|
| Rate for Payer: Cofinity Commercial |
$855.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.43
|
| Rate for Payer: Healthscope Commercial |
$894.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.15
|
| Rate for Payer: Nomi Health Commercial |
$815.32
|
| Rate for Payer: PHP Commercial |
$845.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.29
|
| Rate for Payer: Priority Health HMO/PPO |
$865.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.98
|
| Rate for Payer: UHC Core |
$830.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.72
|
|
