|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$5.80
|
|
|
Service Code
|
NDC 60687063411
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$5.22 |
| Rate for Payer: Aetna Commercial |
$4.93
|
| Rate for Payer: Aetna Medicare |
$1.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.81
|
| Rate for Payer: BCBS Complete |
$1.07
|
| Rate for Payer: BCBS MAPPO |
$1.45
|
| Rate for Payer: BCBS Trust/PPO |
$4.77
|
| Rate for Payer: BCN Commercial |
$4.77
|
| Rate for Payer: BCN Medicare Advantage |
$1.45
|
| Rate for Payer: Cash Price |
$4.64
|
| Rate for Payer: Cofinity Commercial |
$4.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.45
|
| Rate for Payer: Healthscope Commercial |
$5.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.35
|
| Rate for Payer: Mclaren Medicaid |
$1.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.52
|
| Rate for Payer: Meridian Medicaid |
$1.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.93
|
| Rate for Payer: Nomi Health Commercial |
$4.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.35
|
| Rate for Payer: PACE Senior Care Partners |
$1.38
|
| Rate for Payer: PACE SWMI |
$1.45
|
| Rate for Payer: PHP Commercial |
$4.93
|
| Rate for Payer: PHP Medicare Advantage |
$1.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.05
|
| Rate for Payer: Priority Health Medicare |
$1.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.10
|
| Rate for Payer: UHC Core |
$4.84
|
| Rate for Payer: UHC Exchange |
$1.45
|
| Rate for Payer: UHC Medicaid |
$1.02
|
| Rate for Payer: UHC Medicare Advantage |
$1.45
|
| Rate for Payer: UHCCP Medicaid |
$1.02
|
| Rate for Payer: VA VA |
$1.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.35
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$5.96
|
|
|
Service Code
|
NDC 50268074811
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$5.07
|
| Rate for Payer: Aetna Medicare |
$1.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.86
|
| Rate for Payer: BCBS Complete |
$1.10
|
| Rate for Payer: BCBS MAPPO |
$1.49
|
| Rate for Payer: BCBS Trust/PPO |
$4.90
|
| Rate for Payer: BCN Commercial |
$4.90
|
| Rate for Payer: BCN Medicare Advantage |
$1.49
|
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Cofinity Commercial |
$5.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.49
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.47
|
| Rate for Payer: Mclaren Medicaid |
$1.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.56
|
| Rate for Payer: Meridian Medicaid |
$1.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.07
|
| Rate for Payer: Nomi Health Commercial |
$4.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.47
|
| Rate for Payer: PACE Senior Care Partners |
$1.42
|
| Rate for Payer: PACE SWMI |
$1.49
|
| Rate for Payer: PHP Commercial |
$5.07
|
| Rate for Payer: PHP Medicare Advantage |
$1.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.19
|
| Rate for Payer: Priority Health Medicare |
$1.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.24
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Exchange |
$1.49
|
| Rate for Payer: UHC Medicaid |
$1.05
|
| Rate for Payer: UHC Medicare Advantage |
$1.49
|
| Rate for Payer: UHCCP Medicaid |
$1.05
|
| Rate for Payer: VA VA |
$1.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.47
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$3,250.08
|
|
|
Service Code
|
NDC 00078035934
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,262.06 |
| Max. Negotiated Rate |
$2,925.07 |
| Rate for Payer: Aetna Commercial |
$2,762.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,684.24
|
| Rate for Payer: BCN Commercial |
$2,684.24
|
| Rate for Payer: Cash Price |
$2,600.06
|
| Rate for Payer: Cofinity Commercial |
$2,795.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,600.06
|
| Rate for Payer: Healthscope Commercial |
$2,925.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,437.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,762.57
|
| Rate for Payer: Nomi Health Commercial |
$2,665.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,437.56
|
| Rate for Payer: PHP Commercial |
$2,762.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,827.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,262.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,860.07
|
| Rate for Payer: UHC Core |
$2,713.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,437.56
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$3,250.08
|
|
|
Service Code
|
NDC 00078035934
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$572.99 |
| Max. Negotiated Rate |
$2,925.07 |
| Rate for Payer: Aetna Commercial |
$2,762.57
|
| Rate for Payer: Aetna Medicare |
$845.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.65
|
| Rate for Payer: BCBS Complete |
$601.59
|
| Rate for Payer: BCBS MAPPO |
$812.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,671.89
|
| Rate for Payer: BCN Commercial |
$2,671.89
|
| Rate for Payer: BCN Medicare Advantage |
$812.52
|
| Rate for Payer: Cash Price |
$2,600.06
|
| Rate for Payer: Cofinity Commercial |
$2,795.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,600.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.52
|
| Rate for Payer: Healthscope Commercial |
$2,925.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,437.56
|
| Rate for Payer: Mclaren Medicaid |
$572.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.15
|
| Rate for Payer: Meridian Medicaid |
$601.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$893.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,762.57
|
| Rate for Payer: Nomi Health Commercial |
$2,665.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,437.56
|
| Rate for Payer: PACE Senior Care Partners |
$771.89
|
| Rate for Payer: PACE SWMI |
$812.52
|
| Rate for Payer: PHP Commercial |
$2,762.57
|
| Rate for Payer: PHP Medicare Advantage |
$812.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,827.57
|
| Rate for Payer: Priority Health Medicare |
$820.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,262.06
|
| Rate for Payer: Railroad Medicare Medicare |
$812.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,860.07
|
| Rate for Payer: UHC Core |
$2,713.82
|
| Rate for Payer: UHC Exchange |
$812.52
|
| Rate for Payer: UHC Medicaid |
$572.99
|
| Rate for Payer: UHC Medicare Advantage |
$812.52
|
| Rate for Payer: UHCCP Medicaid |
$572.99
|
| Rate for Payer: VA VA |
$812.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,437.56
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$5.80
|
|
|
Service Code
|
NDC 60687063411
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$5.22 |
| Rate for Payer: Aetna Commercial |
$4.93
|
| Rate for Payer: BCBS Trust/PPO |
$4.79
|
| Rate for Payer: BCN Commercial |
$4.79
|
| Rate for Payer: Cash Price |
$4.64
|
| Rate for Payer: Cofinity Commercial |
$4.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.64
|
| Rate for Payer: Healthscope Commercial |
$5.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.93
|
| Rate for Payer: Nomi Health Commercial |
$4.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.35
|
| Rate for Payer: PHP Commercial |
$4.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.10
|
| Rate for Payer: UHC Core |
$4.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.35
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$579.36
|
|
|
Service Code
|
NDC 60687063401
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.14 |
| Max. Negotiated Rate |
$521.42 |
| Rate for Payer: Aetna Commercial |
$492.46
|
| Rate for Payer: Aetna Medicare |
$150.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.05
|
| Rate for Payer: BCBS Complete |
$107.24
|
| Rate for Payer: BCBS MAPPO |
$144.84
|
| Rate for Payer: BCBS Trust/PPO |
$476.29
|
| Rate for Payer: BCN Commercial |
$476.29
|
| Rate for Payer: BCN Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$463.49
|
| Rate for Payer: Cofinity Commercial |
$498.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$463.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.84
|
| Rate for Payer: Healthscope Commercial |
$521.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$434.52
|
| Rate for Payer: Mclaren Medicaid |
$102.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.08
|
| Rate for Payer: Meridian Medicaid |
$107.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$492.46
|
| Rate for Payer: Nomi Health Commercial |
$475.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$434.52
|
| Rate for Payer: PACE Senior Care Partners |
$137.60
|
| Rate for Payer: PACE SWMI |
$144.84
|
| Rate for Payer: PHP Commercial |
$492.46
|
| Rate for Payer: PHP Medicare Advantage |
$144.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$504.04
|
| Rate for Payer: Priority Health Medicare |
$146.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.23
|
| Rate for Payer: Railroad Medicare Medicare |
$144.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.84
|
| Rate for Payer: UHC Core |
$483.77
|
| Rate for Payer: UHC Exchange |
$144.84
|
| Rate for Payer: UHC Medicaid |
$102.14
|
| Rate for Payer: UHC Medicare Advantage |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$102.14
|
| Rate for Payer: VA VA |
$144.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$434.52
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$297.60
|
|
|
Service Code
|
NDC 50268074815
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.47 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: Aetna Medicare |
$77.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.00
|
| Rate for Payer: BCBS Complete |
$55.09
|
| Rate for Payer: BCBS MAPPO |
$74.40
|
| Rate for Payer: BCBS Trust/PPO |
$244.66
|
| Rate for Payer: BCN Commercial |
$244.66
|
| Rate for Payer: BCN Medicare Advantage |
$74.40
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.40
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: Mclaren Medicaid |
$52.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.12
|
| Rate for Payer: Meridian Medicaid |
$55.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Nomi Health Commercial |
$244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PACE Senior Care Partners |
$70.68
|
| Rate for Payer: PACE SWMI |
$74.40
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: PHP Medicare Advantage |
$74.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.91
|
| Rate for Payer: Priority Health Medicare |
$75.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.13
|
| Rate for Payer: Railroad Medicare Medicare |
$74.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.89
|
| Rate for Payer: UHC Core |
$248.50
|
| Rate for Payer: UHC Exchange |
$74.40
|
| Rate for Payer: UHC Medicaid |
$52.47
|
| Rate for Payer: UHC Medicare Advantage |
$74.40
|
| Rate for Payer: UHCCP Medicaid |
$52.47
|
| Rate for Payer: VA VA |
$74.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
OP
|
$233.42
|
|
|
Service Code
|
NDC 65862057290
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.15 |
| Max. Negotiated Rate |
$210.08 |
| Rate for Payer: Aetna Commercial |
$198.41
|
| Rate for Payer: Aetna Medicare |
$60.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.94
|
| Rate for Payer: BCBS Complete |
$43.21
|
| Rate for Payer: BCBS MAPPO |
$58.35
|
| Rate for Payer: BCBS Trust/PPO |
$191.89
|
| Rate for Payer: BCN Commercial |
$191.89
|
| Rate for Payer: BCN Medicare Advantage |
$58.35
|
| Rate for Payer: Cash Price |
$186.74
|
| Rate for Payer: Cofinity Commercial |
$200.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.35
|
| Rate for Payer: Healthscope Commercial |
$210.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.06
|
| Rate for Payer: Mclaren Medicaid |
$41.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.27
|
| Rate for Payer: Meridian Medicaid |
$43.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.41
|
| Rate for Payer: Nomi Health Commercial |
$191.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.06
|
| Rate for Payer: PACE Senior Care Partners |
$55.44
|
| Rate for Payer: PACE SWMI |
$58.35
|
| Rate for Payer: PHP Commercial |
$198.41
|
| Rate for Payer: PHP Medicare Advantage |
$58.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.08
|
| Rate for Payer: Priority Health Medicare |
$58.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.46
|
| Rate for Payer: Railroad Medicare Medicare |
$58.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.41
|
| Rate for Payer: UHC Core |
$194.91
|
| Rate for Payer: UHC Exchange |
$58.35
|
| Rate for Payer: UHC Medicaid |
$41.15
|
| Rate for Payer: UHC Medicare Advantage |
$58.35
|
| Rate for Payer: UHCCP Medicaid |
$41.15
|
| Rate for Payer: VA VA |
$58.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.06
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$297.60
|
|
|
Service Code
|
NDC 50268074815
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$207.13 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: BCBS Trust/PPO |
$245.79
|
| Rate for Payer: BCN Commercial |
$245.79
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Nomi Health Commercial |
$244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.89
|
| Rate for Payer: UHC Core |
$248.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$579.36
|
|
|
Service Code
|
NDC 60687063401
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$403.23 |
| Max. Negotiated Rate |
$521.42 |
| Rate for Payer: Aetna Commercial |
$492.46
|
| Rate for Payer: BCBS Trust/PPO |
$478.49
|
| Rate for Payer: BCN Commercial |
$478.49
|
| Rate for Payer: Cash Price |
$463.49
|
| Rate for Payer: Cofinity Commercial |
$498.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$463.49
|
| Rate for Payer: Healthscope Commercial |
$521.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$434.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$492.46
|
| Rate for Payer: Nomi Health Commercial |
$475.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$434.52
|
| Rate for Payer: PHP Commercial |
$492.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$504.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.84
|
| Rate for Payer: UHC Core |
$483.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$434.52
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$233.42
|
|
|
Service Code
|
NDC 65862057290
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.46 |
| Max. Negotiated Rate |
$210.08 |
| Rate for Payer: Aetna Commercial |
$198.41
|
| Rate for Payer: BCBS Trust/PPO |
$192.78
|
| Rate for Payer: BCN Commercial |
$192.78
|
| Rate for Payer: Cash Price |
$186.74
|
| Rate for Payer: Cofinity Commercial |
$200.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.74
|
| Rate for Payer: Healthscope Commercial |
$210.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.41
|
| Rate for Payer: Nomi Health Commercial |
$191.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.06
|
| Rate for Payer: PHP Commercial |
$198.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.41
|
| Rate for Payer: UHC Core |
$194.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.06
|
|
|
VALSARTAN 160 MG TABLET
|
Facility
|
IP
|
$5.96
|
|
|
Service Code
|
NDC 50268074811
|
| Hospital Charge Code |
31210
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$5.07
|
| Rate for Payer: BCBS Trust/PPO |
$4.92
|
| Rate for Payer: BCN Commercial |
$4.92
|
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Cofinity Commercial |
$5.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.77
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.07
|
| Rate for Payer: Nomi Health Commercial |
$4.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.47
|
| Rate for Payer: PHP Commercial |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.24
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.47
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
IP
|
$117.80
|
|
|
Service Code
|
NDC 60687061221
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.99 |
| Max. Negotiated Rate |
$106.02 |
| Rate for Payer: Aetna Commercial |
$100.13
|
| Rate for Payer: BCBS Trust/PPO |
$97.29
|
| Rate for Payer: BCN Commercial |
$97.29
|
| Rate for Payer: Cash Price |
$94.24
|
| Rate for Payer: Cofinity Commercial |
$101.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.24
|
| Rate for Payer: Healthscope Commercial |
$106.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.13
|
| Rate for Payer: Nomi Health Commercial |
$96.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.35
|
| Rate for Payer: PHP Commercial |
$100.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.66
|
| Rate for Payer: UHC Core |
$98.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.35
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
OP
|
$70.68
|
|
|
Service Code
|
NDC 00378580793
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$63.61 |
| Rate for Payer: Aetna Commercial |
$60.08
|
| Rate for Payer: Aetna Medicare |
$18.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.09
|
| Rate for Payer: BCBS Complete |
$13.08
|
| Rate for Payer: BCBS MAPPO |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$58.11
|
| Rate for Payer: BCN Medicare Advantage |
$17.67
|
| Rate for Payer: Cash Price |
$56.54
|
| Rate for Payer: Cofinity Commercial |
$60.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.67
|
| Rate for Payer: Healthscope Commercial |
$63.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.01
|
| Rate for Payer: Mclaren Medicaid |
$12.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.55
|
| Rate for Payer: Meridian Medicaid |
$13.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.08
|
| Rate for Payer: Nomi Health Commercial |
$57.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.01
|
| Rate for Payer: PACE Senior Care Partners |
$16.79
|
| Rate for Payer: PACE SWMI |
$17.67
|
| Rate for Payer: PHP Commercial |
$60.08
|
| Rate for Payer: PHP Medicare Advantage |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.49
|
| Rate for Payer: Priority Health Medicare |
$17.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.19
|
| Rate for Payer: Railroad Medicare Medicare |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.20
|
| Rate for Payer: UHC Core |
$59.02
|
| Rate for Payer: UHC Exchange |
$17.67
|
| Rate for Payer: UHC Medicaid |
$12.46
|
| Rate for Payer: UHC Medicare Advantage |
$17.67
|
| Rate for Payer: UHCCP Medicaid |
$12.46
|
| Rate for Payer: VA VA |
$17.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.01
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
IP
|
$842.83
|
|
|
Service Code
|
NDC 00078042315
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$586.61 |
| Max. Negotiated Rate |
$758.55 |
| Rate for Payer: Aetna Commercial |
$716.41
|
| Rate for Payer: BCBS Trust/PPO |
$696.09
|
| Rate for Payer: BCN Commercial |
$696.09
|
| Rate for Payer: Cash Price |
$674.26
|
| Rate for Payer: Cofinity Commercial |
$724.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.26
|
| Rate for Payer: Healthscope Commercial |
$758.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.41
|
| Rate for Payer: Nomi Health Commercial |
$691.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.12
|
| Rate for Payer: PHP Commercial |
$716.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$733.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$741.69
|
| Rate for Payer: UHC Core |
$703.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.12
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
IP
|
$3.93
|
|
|
Service Code
|
NDC 60687061211
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$3.54 |
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: BCBS Trust/PPO |
$3.25
|
| Rate for Payer: BCN Commercial |
$3.25
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: Nomi Health Commercial |
$3.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.95
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.46
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.95
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
OP
|
$842.83
|
|
|
Service Code
|
NDC 00078042315
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.59 |
| Max. Negotiated Rate |
$758.55 |
| Rate for Payer: Aetna Commercial |
$716.41
|
| Rate for Payer: Aetna Medicare |
$219.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.38
|
| Rate for Payer: BCBS Complete |
$156.01
|
| Rate for Payer: BCBS MAPPO |
$210.71
|
| Rate for Payer: BCBS Trust/PPO |
$692.89
|
| Rate for Payer: BCN Commercial |
$692.89
|
| Rate for Payer: BCN Medicare Advantage |
$210.71
|
| Rate for Payer: Cash Price |
$674.26
|
| Rate for Payer: Cofinity Commercial |
$724.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.71
|
| Rate for Payer: Healthscope Commercial |
$758.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.12
|
| Rate for Payer: Mclaren Medicaid |
$148.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.24
|
| Rate for Payer: Meridian Medicaid |
$156.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.41
|
| Rate for Payer: Nomi Health Commercial |
$691.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.12
|
| Rate for Payer: PACE Senior Care Partners |
$200.17
|
| Rate for Payer: PACE SWMI |
$210.71
|
| Rate for Payer: PHP Commercial |
$716.41
|
| Rate for Payer: PHP Medicare Advantage |
$210.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$733.26
|
| Rate for Payer: Priority Health Medicare |
$212.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.61
|
| Rate for Payer: Railroad Medicare Medicare |
$210.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$741.69
|
| Rate for Payer: UHC Core |
$703.76
|
| Rate for Payer: UHC Exchange |
$210.71
|
| Rate for Payer: UHC Medicaid |
$148.59
|
| Rate for Payer: UHC Medicare Advantage |
$210.71
|
| Rate for Payer: UHCCP Medicaid |
$148.59
|
| Rate for Payer: VA VA |
$210.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.12
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
OP
|
$117.80
|
|
|
Service Code
|
NDC 60687061221
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.77 |
| Max. Negotiated Rate |
$106.02 |
| Rate for Payer: Aetna Commercial |
$100.13
|
| Rate for Payer: Aetna Medicare |
$30.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.81
|
| Rate for Payer: BCBS Complete |
$21.80
|
| Rate for Payer: BCBS MAPPO |
$29.45
|
| Rate for Payer: BCBS Trust/PPO |
$96.84
|
| Rate for Payer: BCN Commercial |
$96.84
|
| Rate for Payer: BCN Medicare Advantage |
$29.45
|
| Rate for Payer: Cash Price |
$94.24
|
| Rate for Payer: Cofinity Commercial |
$101.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.45
|
| Rate for Payer: Healthscope Commercial |
$106.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.35
|
| Rate for Payer: Mclaren Medicaid |
$20.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.92
|
| Rate for Payer: Meridian Medicaid |
$21.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.13
|
| Rate for Payer: Nomi Health Commercial |
$96.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.35
|
| Rate for Payer: PACE Senior Care Partners |
$27.98
|
| Rate for Payer: PACE SWMI |
$29.45
|
| Rate for Payer: PHP Commercial |
$100.13
|
| Rate for Payer: PHP Medicare Advantage |
$29.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.49
|
| Rate for Payer: Priority Health Medicare |
$29.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.99
|
| Rate for Payer: Railroad Medicare Medicare |
$29.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.66
|
| Rate for Payer: UHC Core |
$98.36
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicaid |
$20.77
|
| Rate for Payer: UHC Medicare Advantage |
$29.45
|
| Rate for Payer: UHCCP Medicaid |
$20.77
|
| Rate for Payer: VA VA |
$29.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.35
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
OP
|
$3.93
|
|
|
Service Code
|
NDC 60687061211
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$3.54 |
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna Medicare |
$1.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.23
|
| Rate for Payer: BCBS Complete |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.98
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Medicare Advantage |
$0.98
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.98
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.95
|
| Rate for Payer: Mclaren Medicaid |
$0.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.03
|
| Rate for Payer: Meridian Medicaid |
$0.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: Nomi Health Commercial |
$3.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.95
|
| Rate for Payer: PACE Senior Care Partners |
$0.93
|
| Rate for Payer: PACE SWMI |
$0.98
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: PHP Medicare Advantage |
$0.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.42
|
| Rate for Payer: Priority Health Medicare |
$0.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.74
|
| Rate for Payer: Railroad Medicare Medicare |
$0.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.46
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$0.98
|
| Rate for Payer: UHC Medicaid |
$0.69
|
| Rate for Payer: UHC Medicare Advantage |
$0.98
|
| Rate for Payer: UHCCP Medicaid |
$0.69
|
| Rate for Payer: VA VA |
$0.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.95
|
|
|
VALSARTAN 40 MG TABLET
|
Facility
|
IP
|
$70.68
|
|
|
Service Code
|
NDC 00378580793
|
| Hospital Charge Code |
33541
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.19 |
| Max. Negotiated Rate |
$63.61 |
| Rate for Payer: Aetna Commercial |
$60.08
|
| Rate for Payer: BCBS Trust/PPO |
$58.37
|
| Rate for Payer: BCN Commercial |
$58.37
|
| Rate for Payer: Cash Price |
$56.54
|
| Rate for Payer: Cofinity Commercial |
$60.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.54
|
| Rate for Payer: Healthscope Commercial |
$63.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.08
|
| Rate for Payer: Nomi Health Commercial |
$57.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.01
|
| Rate for Payer: PHP Commercial |
$60.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.20
|
| Rate for Payer: UHC Core |
$59.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.01
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
IP
|
$15.29
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$13.76 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Commercial |
$20.64
|
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$18.86
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: BCBS Trust/PPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$20.17
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$17.05
|
| Rate for Payer: BCBS Trust/PPO |
$21.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.33
|
| Rate for Payer: BCN Commercial |
$18.33
|
| Rate for Payer: BCN Commercial |
$25.64
|
| Rate for Payer: BCN Commercial |
$17.05
|
| Rate for Payer: BCN Commercial |
$12.63
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Commercial |
$19.52
|
| Rate for Payer: BCN Commercial |
$21.04
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$19.42
|
| Rate for Payer: Cofinity Commercial |
$20.88
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Healthscope Commercial |
$19.97
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$13.76
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Nomi Health Commercial |
$12.54
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$19.91
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.28
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Commercial |
$18.86
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Commercial |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC Core |
$20.27
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Core |
$25.92
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Core |
$17.23
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Core |
$20.39
|
| Rate for Payer: UHC Core |
$18.53
|
| Rate for Payer: UHC Core |
$19.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.32
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
OP
|
$15.29
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$13.76 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: Aetna Commercial |
$18.86
|
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: Aetna Commercial |
$20.64
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Aetna Medicare |
$6.31
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Aetna Medicare |
$8.07
|
| Rate for Payer: Aetna Medicare |
$6.14
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Aetna Medicare |
$6.62
|
| Rate for Payer: Aetna Medicare |
$6.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.70
|
| Rate for Payer: BCBS Complete |
$4.49
|
| Rate for Payer: BCBS Complete |
$5.75
|
| Rate for Payer: BCBS Complete |
$3.43
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS Complete |
$3.82
|
| Rate for Payer: BCBS Complete |
$4.37
|
| Rate for Payer: BCBS Complete |
$4.71
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS Complete |
$4.52
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS MAPPO |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCBS MAPPO |
$6.11
|
| Rate for Payer: BCBS MAPPO |
$4.63
|
| Rate for Payer: BCBS MAPPO |
$6.07
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS MAPPO |
$6.37
|
| Rate for Payer: BCBS MAPPO |
$7.76
|
| Rate for Payer: BCBS Trust/PPO |
$12.57
|
| Rate for Payer: BCBS Trust/PPO |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCBS Trust/PPO |
$18.24
|
| Rate for Payer: BCBS Trust/PPO |
$16.97
|
| Rate for Payer: BCBS Trust/PPO |
$19.43
|
| Rate for Payer: BCBS Trust/PPO |
$20.08
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCN Commercial |
$20.94
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Commercial |
$12.57
|
| Rate for Payer: BCN Commercial |
$19.43
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Commercial |
$25.52
|
| Rate for Payer: BCN Commercial |
$18.24
|
| Rate for Payer: BCN Commercial |
$16.97
|
| Rate for Payer: BCN Commercial |
$20.08
|
| Rate for Payer: BCN Medicare Advantage |
$4.63
|
| Rate for Payer: BCN Medicare Advantage |
$6.07
|
| Rate for Payer: BCN Medicare Advantage |
$5.91
|
| Rate for Payer: BCN Medicare Advantage |
$7.76
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: BCN Medicare Advantage |
$6.37
|
| Rate for Payer: BCN Medicare Advantage |
$6.11
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$19.42
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$20.88
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$19.97
|
| Rate for Payer: Healthscope Commercial |
$13.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.64
|
| Rate for Payer: Mclaren Medicaid |
$3.64
|
| Rate for Payer: Mclaren Medicaid |
$4.49
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Mclaren Medicaid |
$5.47
|
| Rate for Payer: Mclaren Medicaid |
$4.28
|
| Rate for Payer: Mclaren Medicaid |
$2.70
|
| Rate for Payer: Mclaren Medicaid |
$3.27
|
| Rate for Payer: Mclaren Medicaid |
$4.17
|
| Rate for Payer: Mclaren Medicaid |
$4.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Medicaid |
$5.75
|
| Rate for Payer: Meridian Medicaid |
$4.49
|
| Rate for Payer: Meridian Medicaid |
$4.37
|
| Rate for Payer: Meridian Medicaid |
$3.43
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$4.52
|
| Rate for Payer: Meridian Medicaid |
$4.71
|
| Rate for Payer: Meridian Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$12.54
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$19.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.21
|
| Rate for Payer: PACE Senior Care Partners |
$5.80
|
| Rate for Payer: PACE Senior Care Partners |
$7.37
|
| Rate for Payer: PACE Senior Care Partners |
$5.61
|
| Rate for Payer: PACE Senior Care Partners |
$5.77
|
| Rate for Payer: PACE Senior Care Partners |
$4.40
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE Senior Care Partners |
$6.05
|
| Rate for Payer: PACE Senior Care Partners |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PACE SWMI |
$6.11
|
| Rate for Payer: PACE SWMI |
$7.76
|
| Rate for Payer: PACE SWMI |
$5.91
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PACE SWMI |
$6.37
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PACE SWMI |
$4.63
|
| Rate for Payer: PACE SWMI |
$6.07
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: PHP Commercial |
$18.86
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Commercial |
$20.64
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.91
|
| Rate for Payer: PHP Medicare Advantage |
$4.63
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: PHP Medicare Advantage |
$7.76
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.37
|
| Rate for Payer: PHP Medicare Advantage |
$6.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.30
|
| Rate for Payer: Priority Health Medicare |
$5.21
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health Medicare |
$6.13
|
| Rate for Payer: Priority Health Medicare |
$5.97
|
| Rate for Payer: Priority Health Medicare |
$6.17
|
| Rate for Payer: Priority Health Medicare |
$4.68
|
| Rate for Payer: Priority Health Medicare |
$6.43
|
| Rate for Payer: Priority Health Medicare |
$3.86
|
| Rate for Payer: Priority Health Medicare |
$7.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.07
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: Railroad Medicare Medicare |
$6.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.79
|
| Rate for Payer: UHC Core |
$17.23
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Core |
$25.92
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Core |
$19.73
|
| Rate for Payer: UHC Core |
$20.39
|
| Rate for Payer: UHC Core |
$18.53
|
| Rate for Payer: UHC Core |
$20.27
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Exchange |
$6.11
|
| Rate for Payer: UHC Exchange |
$6.07
|
| Rate for Payer: UHC Exchange |
$6.37
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UHC Exchange |
$7.76
|
| Rate for Payer: UHC Exchange |
$5.16
|
| Rate for Payer: UHC Exchange |
$3.82
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Exchange |
$5.91
|
| Rate for Payer: UHC Medicaid |
$5.47
|
| Rate for Payer: UHC Medicaid |
$4.31
|
| Rate for Payer: UHC Medicaid |
$3.27
|
| Rate for Payer: UHC Medicaid |
$3.64
|
| Rate for Payer: UHC Medicaid |
$4.28
|
| Rate for Payer: UHC Medicaid |
$4.49
|
| Rate for Payer: UHC Medicaid |
$2.70
|
| Rate for Payer: UHC Medicaid |
$3.91
|
| Rate for Payer: UHC Medicaid |
$4.17
|
| Rate for Payer: UHC Medicare Advantage |
$4.63
|
| Rate for Payer: UHC Medicare Advantage |
$7.76
|
| Rate for Payer: UHC Medicare Advantage |
$6.37
|
| Rate for Payer: UHC Medicare Advantage |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$6.07
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: UHC Medicare Advantage |
$5.91
|
| Rate for Payer: UHC Medicare Advantage |
$6.11
|
| Rate for Payer: UHC Medicare Advantage |
$5.16
|
| Rate for Payer: UHCCP Medicaid |
$4.31
|
| Rate for Payer: UHCCP Medicaid |
$3.27
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$4.49
|
| Rate for Payer: UHCCP Medicaid |
$5.47
|
| Rate for Payer: UHCCP Medicaid |
$3.91
|
| Rate for Payer: UHCCP Medicaid |
$4.28
|
| Rate for Payer: UHCCP Medicaid |
$4.17
|
| Rate for Payer: UHCCP Medicaid |
$2.70
|
| Rate for Payer: VA VA |
$6.37
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: VA VA |
$5.16
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: VA VA |
$6.07
|
| Rate for Payer: VA VA |
$4.63
|
| Rate for Payer: VA VA |
$5.91
|
| Rate for Payer: VA VA |
$6.11
|
| Rate for Payer: VA VA |
$7.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.32
|
|
|
VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$37.83
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189454
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.33 |
| Max. Negotiated Rate |
$34.05 |
| Rate for Payer: Aetna Commercial |
$32.16
|
| Rate for Payer: Aetna Commercial |
$35.56
|
| Rate for Payer: Aetna Commercial |
$45.21
|
| Rate for Payer: BCBS Trust/PPO |
$34.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.24
|
| Rate for Payer: BCBS Trust/PPO |
$43.93
|
| Rate for Payer: BCN Commercial |
$34.55
|
| Rate for Payer: BCN Commercial |
$31.24
|
| Rate for Payer: BCN Commercial |
$43.93
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cash Price |
$42.55
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$45.74
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.55
|
| Rate for Payer: Healthscope Commercial |
$37.65
|
| Rate for Payer: Healthscope Commercial |
$34.05
|
| Rate for Payer: Healthscope Commercial |
$47.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.21
|
| Rate for Payer: Nomi Health Commercial |
$31.02
|
| Rate for Payer: Nomi Health Commercial |
$34.30
|
| Rate for Payer: Nomi Health Commercial |
$43.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.89
|
| Rate for Payer: PHP Commercial |
$32.16
|
| Rate for Payer: PHP Commercial |
$45.21
|
| Rate for Payer: PHP Commercial |
$35.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.29
|
| Rate for Payer: UHC Core |
$31.59
|
| Rate for Payer: UHC Core |
$44.41
|
| Rate for Payer: UHC Core |
$34.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.37
|
|
|
VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$37.83
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189454
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$34.05 |
| Rate for Payer: Aetna Commercial |
$32.16
|
| Rate for Payer: Aetna Commercial |
$45.21
|
| Rate for Payer: Aetna Commercial |
$35.56
|
| Rate for Payer: Aetna Medicare |
$13.83
|
| Rate for Payer: Aetna Medicare |
$9.84
|
| Rate for Payer: Aetna Medicare |
$10.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.62
|
| Rate for Payer: BCBS Complete |
$7.74
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$13.30
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$10.46
|
| Rate for Payer: BCBS Trust/PPO |
$31.10
|
| Rate for Payer: BCBS Trust/PPO |
$34.39
|
| Rate for Payer: BCBS Trust/PPO |
$43.73
|
| Rate for Payer: BCN Commercial |
$34.39
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: BCN Commercial |
$31.10
|
| Rate for Payer: BCN Medicare Advantage |
$13.30
|
| Rate for Payer: BCN Medicare Advantage |
$10.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$42.55
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Commercial |
$45.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$37.65
|
| Rate for Payer: Healthscope Commercial |
$34.05
|
| Rate for Payer: Healthscope Commercial |
$47.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.37
|
| Rate for Payer: Mclaren Medicaid |
$6.67
|
| Rate for Payer: Mclaren Medicaid |
$9.38
|
| Rate for Payer: Mclaren Medicaid |
$7.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.96
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: Meridian Medicaid |
$7.00
|
| Rate for Payer: Meridian Medicaid |
$7.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$43.62
|
| Rate for Payer: Nomi Health Commercial |
$34.30
|
| Rate for Payer: Nomi Health Commercial |
$31.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.37
|
| Rate for Payer: PACE Senior Care Partners |
$9.93
|
| Rate for Payer: PACE Senior Care Partners |
$8.98
|
| Rate for Payer: PACE Senior Care Partners |
$12.63
|
| Rate for Payer: PACE SWMI |
$13.30
|
| Rate for Payer: PACE SWMI |
$10.46
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$32.16
|
| Rate for Payer: PHP Commercial |
$45.21
|
| Rate for Payer: PHP Commercial |
$35.56
|
| Rate for Payer: PHP Medicare Advantage |
$10.46
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: PHP Medicare Advantage |
$13.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.28
|
| Rate for Payer: Priority Health Medicare |
$13.43
|
| Rate for Payer: Priority Health Medicare |
$10.56
|
| Rate for Payer: Priority Health Medicare |
$9.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.33
|
| Rate for Payer: Railroad Medicare Medicare |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$13.30
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.29
|
| Rate for Payer: UHC Core |
$31.59
|
| Rate for Payer: UHC Core |
$44.41
|
| Rate for Payer: UHC Core |
$34.93
|
| Rate for Payer: UHC Exchange |
$13.30
|
| Rate for Payer: UHC Exchange |
$10.46
|
| Rate for Payer: UHC Exchange |
$9.46
|
| Rate for Payer: UHC Medicaid |
$6.67
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHC Medicaid |
$7.37
|
| Rate for Payer: UHC Medicare Advantage |
$10.46
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: UHC Medicare Advantage |
$13.30
|
| Rate for Payer: UHCCP Medicaid |
$7.37
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$9.46
|
| Rate for Payer: VA VA |
$13.30
|
| Rate for Payer: VA VA |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.89
|
|
|
VANCOMYCIN 125 MG CAPSULE
|
Facility
|
IP
|
$120.20
|
|
|
Service Code
|
NDC 00121086720
|
| Hospital Charge Code |
11628
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.66 |
| Max. Negotiated Rate |
$108.18 |
| Rate for Payer: Aetna Commercial |
$102.17
|
| Rate for Payer: BCBS Trust/PPO |
$99.27
|
| Rate for Payer: BCN Commercial |
$99.27
|
| Rate for Payer: Cash Price |
$96.16
|
| Rate for Payer: Cofinity Commercial |
$103.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.16
|
| Rate for Payer: Healthscope Commercial |
$108.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.17
|
| Rate for Payer: Nomi Health Commercial |
$98.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.15
|
| Rate for Payer: PHP Commercial |
$102.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.78
|
| Rate for Payer: UHC Core |
$100.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.15
|
|
