|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.62
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$19.46 |
| Rate for Payer: Aetna Commercial |
$18.38
|
| Rate for Payer: Aetna Commercial |
$34.09
|
| Rate for Payer: BCBS Trust/PPO |
$17.86
|
| Rate for Payer: BCBS Trust/PPO |
$33.12
|
| Rate for Payer: BCN Commercial |
$17.86
|
| Rate for Payer: BCN Commercial |
$33.12
|
| Rate for Payer: Cash Price |
$17.30
|
| Rate for Payer: Cash Price |
$32.08
|
| Rate for Payer: Cofinity Commercial |
$34.49
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: Healthscope Commercial |
$36.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.09
|
| Rate for Payer: Nomi Health Commercial |
$17.73
|
| Rate for Payer: Nomi Health Commercial |
$32.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.07
|
| Rate for Payer: PHP Commercial |
$34.09
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.29
|
| Rate for Payer: UHC Core |
$18.05
|
| Rate for Payer: UHC Core |
$33.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.07
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$30.92
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$27.83 |
| Rate for Payer: Aetna Commercial |
$26.28
|
| Rate for Payer: BCBS Trust/PPO |
$25.54
|
| Rate for Payer: BCN Commercial |
$25.54
|
| Rate for Payer: Cash Price |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$26.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.74
|
| Rate for Payer: Healthscope Commercial |
$27.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Nomi Health Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: PHP Commercial |
$26.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.21
|
| Rate for Payer: UHC Core |
$25.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.19
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.62
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$19.46 |
| Rate for Payer: Aetna Commercial |
$18.38
|
| Rate for Payer: Aetna Commercial |
$34.09
|
| Rate for Payer: Aetna Medicare |
$10.43
|
| Rate for Payer: Aetna Medicare |
$5.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.53
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$5.41
|
| Rate for Payer: BCBS MAPPO |
$10.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.77
|
| Rate for Payer: BCBS Trust/PPO |
$32.97
|
| Rate for Payer: BCN Commercial |
$32.97
|
| Rate for Payer: BCN Commercial |
$17.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.03
|
| Rate for Payer: BCN Medicare Advantage |
$5.41
|
| Rate for Payer: Cash Price |
$17.30
|
| Rate for Payer: Cash Price |
$32.08
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$34.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.41
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: Healthscope Commercial |
$36.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.07
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicaid |
$3.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.68
|
| Rate for Payer: Meridian Medicaid |
$4.00
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Nomi Health Commercial |
$32.88
|
| Rate for Payer: Nomi Health Commercial |
$17.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.07
|
| Rate for Payer: PACE Senior Care Partners |
$9.52
|
| Rate for Payer: PACE Senior Care Partners |
$5.13
|
| Rate for Payer: PACE SWMI |
$10.03
|
| Rate for Payer: PACE SWMI |
$5.41
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: PHP Commercial |
$34.09
|
| Rate for Payer: PHP Medicare Advantage |
$5.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.81
|
| Rate for Payer: Priority Health Medicare |
$10.13
|
| Rate for Payer: Priority Health Medicare |
$5.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.41
|
| Rate for Payer: Railroad Medicare Medicare |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.29
|
| Rate for Payer: UHC Core |
$33.48
|
| Rate for Payer: UHC Core |
$18.05
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Exchange |
$5.41
|
| Rate for Payer: UHC Medicaid |
$7.07
|
| Rate for Payer: UHC Medicaid |
$3.81
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: UHC Medicare Advantage |
$10.03
|
| Rate for Payer: UHCCP Medicaid |
$3.81
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: VA VA |
$5.41
|
| Rate for Payer: VA VA |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.21
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$30.92
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$27.83 |
| Rate for Payer: Aetna Commercial |
$26.28
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.66
|
| Rate for Payer: BCBS Complete |
$5.72
|
| Rate for Payer: BCBS MAPPO |
$7.73
|
| Rate for Payer: BCBS Trust/PPO |
$25.42
|
| Rate for Payer: BCN Commercial |
$25.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.73
|
| Rate for Payer: Cash Price |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$26.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.73
|
| Rate for Payer: Healthscope Commercial |
$27.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.19
|
| Rate for Payer: Mclaren Medicaid |
$5.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.12
|
| Rate for Payer: Meridian Medicaid |
$5.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Nomi Health Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: PACE Senior Care Partners |
$7.34
|
| Rate for Payer: PACE SWMI |
$7.73
|
| Rate for Payer: PHP Commercial |
$26.28
|
| Rate for Payer: PHP Medicare Advantage |
$7.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.90
|
| Rate for Payer: Priority Health Medicare |
$7.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.52
|
| Rate for Payer: Railroad Medicare Medicare |
$7.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.21
|
| Rate for Payer: UHC Core |
$25.82
|
| Rate for Payer: UHC Exchange |
$7.73
|
| Rate for Payer: UHC Medicaid |
$5.45
|
| Rate for Payer: UHC Medicare Advantage |
$7.73
|
| Rate for Payer: UHCCP Medicaid |
$5.45
|
| Rate for Payer: VA VA |
$7.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.19
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$940.69
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.84 |
| Max. Negotiated Rate |
$846.62 |
| Rate for Payer: Aetna Commercial |
$799.59
|
| Rate for Payer: Aetna Medicare |
$244.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.97
|
| Rate for Payer: BCBS Complete |
$174.12
|
| Rate for Payer: BCBS MAPPO |
$235.17
|
| Rate for Payer: BCBS Trust/PPO |
$773.34
|
| Rate for Payer: BCN Commercial |
$773.34
|
| Rate for Payer: BCN Medicare Advantage |
$235.17
|
| Rate for Payer: Cash Price |
$752.55
|
| Rate for Payer: Cofinity Commercial |
$808.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.17
|
| Rate for Payer: Healthscope Commercial |
$846.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.52
|
| Rate for Payer: Mclaren Medicaid |
$165.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.93
|
| Rate for Payer: Meridian Medicaid |
$174.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.59
|
| Rate for Payer: Nomi Health Commercial |
$771.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.52
|
| Rate for Payer: PACE Senior Care Partners |
$223.41
|
| Rate for Payer: PACE SWMI |
$235.17
|
| Rate for Payer: PHP Commercial |
$799.59
|
| Rate for Payer: PHP Medicare Advantage |
$235.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$818.40
|
| Rate for Payer: Priority Health Medicare |
$237.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.72
|
| Rate for Payer: Railroad Medicare Medicare |
$235.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.81
|
| Rate for Payer: UHC Core |
$785.48
|
| Rate for Payer: UHC Exchange |
$235.17
|
| Rate for Payer: UHC Medicaid |
$165.84
|
| Rate for Payer: UHC Medicare Advantage |
$235.17
|
| Rate for Payer: UHCCP Medicaid |
$165.84
|
| Rate for Payer: VA VA |
$235.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$244.34
|
|
|
Service Code
|
NDC 43598090856
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.06 |
| Max. Negotiated Rate |
$219.91 |
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: BCBS Trust/PPO |
$201.80
|
| Rate for Payer: BCN Commercial |
$201.80
|
| Rate for Payer: Cash Price |
$195.47
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.47
|
| Rate for Payer: Healthscope Commercial |
$219.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.69
|
| Rate for Payer: Nomi Health Commercial |
$200.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.25
|
| Rate for Payer: PHP Commercial |
$207.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.02
|
| Rate for Payer: UHC Core |
$204.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.25
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$461.80
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.42 |
| Max. Negotiated Rate |
$415.62 |
| Rate for Payer: Aetna Commercial |
$392.53
|
| Rate for Payer: Aetna Medicare |
$120.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.31
|
| Rate for Payer: BCBS Complete |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$115.45
|
| Rate for Payer: BCBS Trust/PPO |
$379.65
|
| Rate for Payer: BCN Commercial |
$379.65
|
| Rate for Payer: BCN Medicare Advantage |
$115.45
|
| Rate for Payer: Cash Price |
$369.44
|
| Rate for Payer: Cofinity Commercial |
$397.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.45
|
| Rate for Payer: Healthscope Commercial |
$415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.35
|
| Rate for Payer: Mclaren Medicaid |
$81.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.22
|
| Rate for Payer: Meridian Medicaid |
$85.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.53
|
| Rate for Payer: Nomi Health Commercial |
$378.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.35
|
| Rate for Payer: PACE Senior Care Partners |
$109.68
|
| Rate for Payer: PACE SWMI |
$115.45
|
| Rate for Payer: PHP Commercial |
$392.53
|
| Rate for Payer: PHP Medicare Advantage |
$115.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.77
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.41
|
| Rate for Payer: Railroad Medicare Medicare |
$115.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.38
|
| Rate for Payer: UHC Core |
$385.60
|
| Rate for Payer: UHC Exchange |
$115.45
|
| Rate for Payer: UHC Medicaid |
$81.42
|
| Rate for Payer: UHC Medicare Advantage |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$81.42
|
| Rate for Payer: VA VA |
$115.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.35
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$940.69
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$654.72 |
| Max. Negotiated Rate |
$846.62 |
| Rate for Payer: Aetna Commercial |
$799.59
|
| Rate for Payer: BCBS Trust/PPO |
$776.92
|
| Rate for Payer: BCN Commercial |
$776.92
|
| Rate for Payer: Cash Price |
$752.55
|
| Rate for Payer: Cofinity Commercial |
$808.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.55
|
| Rate for Payer: Healthscope Commercial |
$846.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.59
|
| Rate for Payer: Nomi Health Commercial |
$771.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.52
|
| Rate for Payer: PHP Commercial |
$799.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$818.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.81
|
| Rate for Payer: UHC Core |
$785.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$461.80
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$321.41 |
| Max. Negotiated Rate |
$415.62 |
| Rate for Payer: Aetna Commercial |
$392.53
|
| Rate for Payer: BCBS Trust/PPO |
$381.40
|
| Rate for Payer: BCN Commercial |
$381.40
|
| Rate for Payer: Cash Price |
$369.44
|
| Rate for Payer: Cofinity Commercial |
$397.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.44
|
| Rate for Payer: Healthscope Commercial |
$415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.53
|
| Rate for Payer: Nomi Health Commercial |
$378.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.35
|
| Rate for Payer: PHP Commercial |
$392.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.38
|
| Rate for Payer: UHC Core |
$385.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.35
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$244.34
|
|
|
Service Code
|
NDC 43598090856
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$219.91 |
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: Aetna Medicare |
$63.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.36
|
| Rate for Payer: BCBS Complete |
$45.23
|
| Rate for Payer: BCBS MAPPO |
$61.09
|
| Rate for Payer: BCBS Trust/PPO |
$200.87
|
| Rate for Payer: BCN Commercial |
$200.87
|
| Rate for Payer: BCN Medicare Advantage |
$61.09
|
| Rate for Payer: Cash Price |
$195.47
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.09
|
| Rate for Payer: Healthscope Commercial |
$219.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.25
|
| Rate for Payer: Mclaren Medicaid |
$43.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.14
|
| Rate for Payer: Meridian Medicaid |
$45.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.69
|
| Rate for Payer: Nomi Health Commercial |
$200.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.25
|
| Rate for Payer: PACE Senior Care Partners |
$58.03
|
| Rate for Payer: PACE SWMI |
$61.09
|
| Rate for Payer: PHP Commercial |
$207.69
|
| Rate for Payer: PHP Medicare Advantage |
$61.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.58
|
| Rate for Payer: Priority Health Medicare |
$61.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.06
|
| Rate for Payer: Railroad Medicare Medicare |
$61.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.02
|
| Rate for Payer: UHC Core |
$204.02
|
| Rate for Payer: UHC Exchange |
$61.09
|
| Rate for Payer: UHC Medicaid |
$43.08
|
| Rate for Payer: UHC Medicare Advantage |
$61.09
|
| Rate for Payer: UHCCP Medicaid |
$43.08
|
| Rate for Payer: VA VA |
$61.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.25
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
IP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: BCBS Trust/PPO |
$35.48
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$35.48
|
| Rate for Payer: BCN Commercial |
$46.19
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$35.23
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$35.87
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
OP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: BCN Commercial |
$35.32
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicaid |
$7.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$7.95
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Nomi Health Commercial |
$35.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PACE Senior Care Partners |
$13.28
|
| Rate for Payer: PACE Senior Care Partners |
$10.20
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.38
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Medicare |
$10.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: UHC Core |
$35.87
|
| Rate for Payer: UHC Exchange |
$13.98
|
| Rate for Payer: UHC Exchange |
$10.74
|
| Rate for Payer: UHC Medicaid |
$9.86
|
| Rate for Payer: UHC Medicaid |
$7.57
|
| Rate for Payer: UHC Medicare Advantage |
$10.74
|
| Rate for Payer: UHC Medicare Advantage |
$13.98
|
| Rate for Payer: UHCCP Medicaid |
$7.57
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$10.74
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$121.65
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.67 |
| Max. Negotiated Rate |
$109.48 |
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: BCBS Trust/PPO |
$35.48
|
| Rate for Payer: BCBS Trust/PPO |
$100.47
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$35.48
|
| Rate for Payer: BCN Commercial |
$100.47
|
| Rate for Payer: BCN Commercial |
$46.19
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$99.75
|
| Rate for Payer: Nomi Health Commercial |
$35.23
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.05
|
| Rate for Payer: UHC Core |
$101.58
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: UHC Core |
$35.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$121.65
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.45 |
| Max. Negotiated Rate |
$109.48 |
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Aetna Medicare |
$31.63
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS Complete |
$22.52
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$30.41
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$100.01
|
| Rate for Payer: BCBS Trust/PPO |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$35.32
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: BCN Commercial |
$100.01
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: BCN Medicare Advantage |
$30.41
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.41
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Mclaren Medicaid |
$21.45
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicaid |
$7.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$22.52
|
| Rate for Payer: Meridian Medicaid |
$7.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Nomi Health Commercial |
$35.23
|
| Rate for Payer: Nomi Health Commercial |
$99.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: PACE Senior Care Partners |
$10.20
|
| Rate for Payer: PACE Senior Care Partners |
$28.89
|
| Rate for Payer: PACE Senior Care Partners |
$13.28
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PACE SWMI |
$30.41
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: PHP Medicare Advantage |
$30.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Medicare |
$10.85
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.67
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: Railroad Medicare Medicare |
$30.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.05
|
| Rate for Payer: UHC Core |
$101.58
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: UHC Core |
$35.87
|
| Rate for Payer: UHC Exchange |
$13.98
|
| Rate for Payer: UHC Exchange |
$10.74
|
| Rate for Payer: UHC Exchange |
$30.41
|
| Rate for Payer: UHC Medicaid |
$21.45
|
| Rate for Payer: UHC Medicaid |
$9.86
|
| Rate for Payer: UHC Medicaid |
$7.57
|
| Rate for Payer: UHC Medicare Advantage |
$10.74
|
| Rate for Payer: UHC Medicare Advantage |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$13.98
|
| Rate for Payer: UHCCP Medicaid |
$7.57
|
| Rate for Payer: UHCCP Medicaid |
$21.45
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$30.41
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: VA VA |
$10.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$330.84
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$230.26 |
| Max. Negotiated Rate |
$297.76 |
| Rate for Payer: Aetna Commercial |
$281.21
|
| Rate for Payer: BCBS Trust/PPO |
$273.24
|
| Rate for Payer: BCN Commercial |
$273.24
|
| Rate for Payer: Cash Price |
$264.67
|
| Rate for Payer: Cofinity Commercial |
$284.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.67
|
| Rate for Payer: Healthscope Commercial |
$297.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.21
|
| Rate for Payer: Nomi Health Commercial |
$271.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.13
|
| Rate for Payer: PHP Commercial |
$281.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.14
|
| Rate for Payer: UHC Core |
$276.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.13
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$178.64
|
|
|
Service Code
|
HCPCS J2596
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$160.78 |
| Rate for Payer: Aetna Commercial |
$151.84
|
| Rate for Payer: Aetna Medicare |
$46.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.83
|
| Rate for Payer: BCBS Complete |
$33.07
|
| Rate for Payer: BCBS MAPPO |
$44.66
|
| Rate for Payer: BCBS Trust/PPO |
$146.86
|
| Rate for Payer: BCN Commercial |
$146.86
|
| Rate for Payer: BCN Medicare Advantage |
$44.66
|
| Rate for Payer: Cash Price |
$142.91
|
| Rate for Payer: Cofinity Commercial |
$153.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.66
|
| Rate for Payer: Healthscope Commercial |
$160.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.98
|
| Rate for Payer: Mclaren Medicaid |
$31.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.89
|
| Rate for Payer: Meridian Medicaid |
$33.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.84
|
| Rate for Payer: Nomi Health Commercial |
$146.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.98
|
| Rate for Payer: PACE Senior Care Partners |
$42.43
|
| Rate for Payer: PACE SWMI |
$44.66
|
| Rate for Payer: PHP Commercial |
$151.84
|
| Rate for Payer: PHP Medicare Advantage |
$44.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.42
|
| Rate for Payer: Priority Health Medicare |
$45.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.33
|
| Rate for Payer: Railroad Medicare Medicare |
$44.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.20
|
| Rate for Payer: UHC Core |
$149.16
|
| Rate for Payer: UHC Exchange |
$44.66
|
| Rate for Payer: UHC Medicaid |
$31.49
|
| Rate for Payer: UHC Medicare Advantage |
$44.66
|
| Rate for Payer: UHCCP Medicaid |
$31.49
|
| Rate for Payer: VA VA |
$44.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.98
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$178.64
|
|
|
Service Code
|
HCPCS J2596
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$124.33 |
| Max. Negotiated Rate |
$160.78 |
| Rate for Payer: Aetna Commercial |
$151.84
|
| Rate for Payer: BCBS Trust/PPO |
$147.54
|
| Rate for Payer: BCN Commercial |
$147.54
|
| Rate for Payer: Cash Price |
$142.91
|
| Rate for Payer: Cofinity Commercial |
$153.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.91
|
| Rate for Payer: Healthscope Commercial |
$160.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.84
|
| Rate for Payer: Nomi Health Commercial |
$146.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.98
|
| Rate for Payer: PHP Commercial |
$151.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.20
|
| Rate for Payer: UHC Core |
$149.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.98
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$330.84
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.33 |
| Max. Negotiated Rate |
$297.76 |
| Rate for Payer: Aetna Commercial |
$281.21
|
| Rate for Payer: Aetna Medicare |
$86.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.39
|
| Rate for Payer: BCBS Complete |
$61.24
|
| Rate for Payer: BCBS MAPPO |
$82.71
|
| Rate for Payer: BCBS Trust/PPO |
$271.98
|
| Rate for Payer: BCN Commercial |
$271.98
|
| Rate for Payer: BCN Medicare Advantage |
$82.71
|
| Rate for Payer: Cash Price |
$264.67
|
| Rate for Payer: Cofinity Commercial |
$284.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.71
|
| Rate for Payer: Healthscope Commercial |
$297.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.13
|
| Rate for Payer: Mclaren Medicaid |
$58.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.85
|
| Rate for Payer: Meridian Medicaid |
$61.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.21
|
| Rate for Payer: Nomi Health Commercial |
$271.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.13
|
| Rate for Payer: PACE Senior Care Partners |
$78.57
|
| Rate for Payer: PACE SWMI |
$82.71
|
| Rate for Payer: PHP Commercial |
$281.21
|
| Rate for Payer: PHP Medicare Advantage |
$82.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.83
|
| Rate for Payer: Priority Health Medicare |
$83.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.26
|
| Rate for Payer: Railroad Medicare Medicare |
$82.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.14
|
| Rate for Payer: UHC Core |
$276.25
|
| Rate for Payer: UHC Exchange |
$82.71
|
| Rate for Payer: UHC Medicaid |
$58.33
|
| Rate for Payer: UHC Medicare Advantage |
$82.71
|
| Rate for Payer: UHCCP Medicaid |
$58.33
|
| Rate for Payer: VA VA |
$82.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.13
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$4.40
|
|
|
Service Code
|
NDC 68084084411
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.96 |
| Rate for Payer: Aetna Commercial |
$3.74
|
| Rate for Payer: BCBS Trust/PPO |
$3.63
|
| Rate for Payer: BCN Commercial |
$3.63
|
| Rate for Payer: Cash Price |
$3.52
|
| Rate for Payer: Cofinity Commercial |
$3.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$3.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.74
|
| Rate for Payer: Nomi Health Commercial |
$3.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.30
|
| Rate for Payer: PHP Commercial |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.87
|
| Rate for Payer: UHC Core |
$3.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.30
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$4.40
|
|
|
Service Code
|
NDC 68084084411
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$3.96 |
| Rate for Payer: Aetna Commercial |
$3.74
|
| Rate for Payer: Aetna Medicare |
$1.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.38
|
| Rate for Payer: BCBS Complete |
$0.81
|
| Rate for Payer: BCBS MAPPO |
$1.10
|
| Rate for Payer: BCBS Trust/PPO |
$3.62
|
| Rate for Payer: BCN Commercial |
$3.62
|
| Rate for Payer: BCN Medicare Advantage |
$1.10
|
| Rate for Payer: Cash Price |
$3.52
|
| Rate for Payer: Cofinity Commercial |
$3.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$3.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.30
|
| Rate for Payer: Mclaren Medicaid |
$0.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.16
|
| Rate for Payer: Meridian Medicaid |
$0.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.74
|
| Rate for Payer: Nomi Health Commercial |
$3.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.30
|
| Rate for Payer: PACE Senior Care Partners |
$1.04
|
| Rate for Payer: PACE SWMI |
$1.10
|
| Rate for Payer: PHP Commercial |
$3.74
|
| Rate for Payer: PHP Medicare Advantage |
$1.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.83
|
| Rate for Payer: Priority Health Medicare |
$1.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.87
|
| Rate for Payer: UHC Core |
$3.67
|
| Rate for Payer: UHC Exchange |
$1.10
|
| Rate for Payer: UHC Medicaid |
$0.78
|
| Rate for Payer: UHC Medicare Advantage |
$1.10
|
| Rate for Payer: UHCCP Medicaid |
$0.78
|
| Rate for Payer: VA VA |
$1.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.30
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$439.68
|
|
|
Service Code
|
NDC 68084084401
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.52 |
| Max. Negotiated Rate |
$395.71 |
| Rate for Payer: Aetna Commercial |
$373.73
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.40
|
| Rate for Payer: BCBS Complete |
$81.38
|
| Rate for Payer: BCBS MAPPO |
$109.92
|
| Rate for Payer: BCBS Trust/PPO |
$361.46
|
| Rate for Payer: BCN Commercial |
$361.46
|
| Rate for Payer: BCN Medicare Advantage |
$109.92
|
| Rate for Payer: Cash Price |
$351.74
|
| Rate for Payer: Cofinity Commercial |
$378.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.92
|
| Rate for Payer: Healthscope Commercial |
$395.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.76
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.42
|
| Rate for Payer: Meridian Medicaid |
$81.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.73
|
| Rate for Payer: Nomi Health Commercial |
$360.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.76
|
| Rate for Payer: PACE Senior Care Partners |
$104.42
|
| Rate for Payer: PACE SWMI |
$109.92
|
| Rate for Payer: PHP Commercial |
$373.73
|
| Rate for Payer: PHP Medicare Advantage |
$109.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$382.52
|
| Rate for Payer: Priority Health Medicare |
$111.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.02
|
| Rate for Payer: Railroad Medicare Medicare |
$109.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.92
|
| Rate for Payer: UHC Core |
$367.13
|
| Rate for Payer: UHC Exchange |
$109.92
|
| Rate for Payer: UHC Medicaid |
$77.52
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: UHCCP Medicaid |
$77.52
|
| Rate for Payer: VA VA |
$109.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.76
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$2.19
|
| Rate for Payer: BCN Commercial |
$2.19
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.33
|
| Rate for Payer: UHC Core |
$2.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$439.68
|
|
|
Service Code
|
NDC 68084084401
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$306.02 |
| Max. Negotiated Rate |
$395.71 |
| Rate for Payer: Aetna Commercial |
$373.73
|
| Rate for Payer: BCBS Trust/PPO |
$363.13
|
| Rate for Payer: BCN Commercial |
$363.13
|
| Rate for Payer: Cash Price |
$351.74
|
| Rate for Payer: Cofinity Commercial |
$378.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.74
|
| Rate for Payer: Healthscope Commercial |
$395.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.73
|
| Rate for Payer: Nomi Health Commercial |
$360.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.76
|
| Rate for Payer: PHP Commercial |
$373.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$382.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.92
|
| Rate for Payer: UHC Core |
$367.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.76
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna Medicare |
$0.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.83
|
| Rate for Payer: BCBS Complete |
$0.49
|
| Rate for Payer: BCBS MAPPO |
$0.66
|
| Rate for Payer: BCBS Trust/PPO |
$2.18
|
| Rate for Payer: BCN Commercial |
$2.18
|
| Rate for Payer: BCN Medicare Advantage |
$0.66
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.66
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Mclaren Medicaid |
$0.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: Meridian Medicaid |
$0.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PACE Senior Care Partners |
$0.63
|
| Rate for Payer: PACE SWMI |
$0.66
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$0.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.31
|
| Rate for Payer: Priority Health Medicare |
$0.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.84
|
| Rate for Payer: Railroad Medicare Medicare |
$0.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.33
|
| Rate for Payer: UHC Core |
$2.21
|
| Rate for Payer: UHC Exchange |
$0.66
|
| Rate for Payer: UHC Medicaid |
$0.47
|
| Rate for Payer: UHC Medicare Advantage |
$0.66
|
| Rate for Payer: UHCCP Medicaid |
$0.47
|
| Rate for Payer: VA VA |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$264.48
|
|
|
Service Code
|
NDC 68084069801
|
| Hospital Charge Code |
27857
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.08 |
| Max. Negotiated Rate |
$238.03 |
| Rate for Payer: Aetna Commercial |
$224.81
|
| Rate for Payer: BCBS Trust/PPO |
$218.43
|
| Rate for Payer: BCN Commercial |
$218.43
|
| Rate for Payer: Cash Price |
$211.58
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.58
|
| Rate for Payer: Healthscope Commercial |
$238.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.81
|
| Rate for Payer: Nomi Health Commercial |
$216.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.36
|
| Rate for Payer: PHP Commercial |
$224.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.74
|
| Rate for Payer: UHC Core |
$220.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.36
|
|
