|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.43
|
|
|
Service Code
|
NDC 60505616901
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$4.61
|
| Rate for Payer: BCBS Trust/PPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$14.33
|
| Rate for Payer: BCN Medicare Advantage |
$4.61
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.61
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: PACE Senior Care Partners |
$4.38
|
| Rate for Payer: PACE SWMI |
$4.61
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: PHP Medicare Advantage |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.61
|
| Rate for Payer: UHC Exchange |
$4.61
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: VA VA |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.05
|
|
|
Service Code
|
NDC 72485010701
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$20.44
|
| Rate for Payer: BCBS Trust/PPO |
$19.63
|
| Rate for Payer: BCN Commercial |
$18.59
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.24
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.44
|
| Rate for Payer: Nomi Health Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$20.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health HMO/PPO |
$20.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.16
|
| Rate for Payer: UHC Core |
$20.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.04
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$31.07
|
|
|
Service Code
|
NDC 00517096010
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$27.96 |
| Rate for Payer: Aetna Commercial |
$26.41
|
| Rate for Payer: BCBS Trust/PPO |
$25.36
|
| Rate for Payer: BCN Commercial |
$24.01
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cofinity Commercial |
$26.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.86
|
| Rate for Payer: Healthscope Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.41
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PHP Commercial |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.20
|
| Rate for Payer: Priority Health HMO/PPO |
$27.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.34
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.30
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.69
|
|
|
Service Code
|
NDC 81284061210
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: BCBS Trust/PPO |
$12.81
|
| Rate for Payer: BCN Commercial |
$12.13
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$31.07
|
|
|
Service Code
|
NDC 00517096001
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$27.96 |
| Rate for Payer: Aetna Commercial |
$26.41
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: BCBS Complete |
$12.43
|
| Rate for Payer: BCBS MAPPO |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.54
|
| Rate for Payer: BCN Commercial |
$24.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.77
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cofinity Commercial |
$26.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.77
|
| Rate for Payer: Healthscope Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.41
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PACE Senior Care Partners |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.77
|
| Rate for Payer: PHP Commercial |
$26.41
|
| Rate for Payer: PHP Medicare Advantage |
$7.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.20
|
| Rate for Payer: Priority Health HMO/PPO |
$27.03
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.34
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.77
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicare Advantage |
$7.77
|
| Rate for Payer: VA VA |
$7.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.30
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$31.07
|
|
|
Service Code
|
NDC 00517096001
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$27.96 |
| Rate for Payer: Aetna Commercial |
$26.41
|
| Rate for Payer: BCBS Trust/PPO |
$25.36
|
| Rate for Payer: BCN Commercial |
$24.01
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cofinity Commercial |
$26.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.86
|
| Rate for Payer: Healthscope Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.41
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PHP Commercial |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.20
|
| Rate for Payer: Priority Health HMO/PPO |
$27.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.34
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.30
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.69
|
|
|
Service Code
|
NDC 81284061210
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.90
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS MAPPO |
$3.92
|
| Rate for Payer: BCBS Trust/PPO |
$12.90
|
| Rate for Payer: BCN Commercial |
$12.20
|
| Rate for Payer: BCN Medicare Advantage |
$3.92
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.92
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: PACE Senior Care Partners |
$3.73
|
| Rate for Payer: PACE SWMI |
$3.92
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Medicare Advantage |
$3.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health Medicare |
$3.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.92
|
| Rate for Payer: UHC Exchange |
$3.92
|
| Rate for Payer: UHC Medicare Advantage |
$3.92
|
| Rate for Payer: VA VA |
$3.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.43
|
|
|
Service Code
|
NDC 60505616900
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$4.61
|
| Rate for Payer: BCBS Trust/PPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$14.33
|
| Rate for Payer: BCN Medicare Advantage |
$4.61
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.61
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: PACE Senior Care Partners |
$4.38
|
| Rate for Payer: PACE SWMI |
$4.61
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: PHP Medicare Advantage |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.61
|
| Rate for Payer: UHC Exchange |
$4.61
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: VA VA |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 67457019710
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.88 |
| Max. Negotiated Rate |
$26.07 |
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna Medicare |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.05
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS MAPPO |
$7.24
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Commercial |
$22.52
|
| Rate for Payer: BCN Medicare Advantage |
$7.24
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.24
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: PACE Senior Care Partners |
$6.88
|
| Rate for Payer: PACE SWMI |
$7.24
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: PHP Medicare Advantage |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health HMO/PPO |
$25.20
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.41
|
| Rate for Payer: Railroad Medicare Medicare |
$7.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.49
|
| Rate for Payer: UHC Core |
$24.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.24
|
| Rate for Payer: UHC Exchange |
$7.24
|
| Rate for Payer: UHC Medicare Advantage |
$7.24
|
| Rate for Payer: VA VA |
$7.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.91
|
|
|
Service Code
|
NDC 55150018810
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$14.32 |
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$12.99
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: Cash Price |
$12.73
|
| Rate for Payer: Cofinity Commercial |
$13.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$14.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.34
|
| Rate for Payer: Priority Health HMO/PPO |
$13.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.00
|
| Rate for Payer: UHC Core |
$13.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.93
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.69
|
|
|
Service Code
|
NDC 81284061200
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.90
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS MAPPO |
$3.92
|
| Rate for Payer: BCBS Trust/PPO |
$12.90
|
| Rate for Payer: BCN Commercial |
$12.20
|
| Rate for Payer: BCN Medicare Advantage |
$3.92
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.92
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: PACE Senior Care Partners |
$3.73
|
| Rate for Payer: PACE SWMI |
$3.92
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Medicare Advantage |
$3.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health Medicare |
$3.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.92
|
| Rate for Payer: UHC Exchange |
$3.92
|
| Rate for Payer: UHC Medicare Advantage |
$3.92
|
| Rate for Payer: VA VA |
$3.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.99
|
|
|
Service Code
|
NDC 39822100001
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.59 |
| Max. Negotiated Rate |
$21.59 |
| Rate for Payer: Aetna Commercial |
$20.39
|
| Rate for Payer: BCBS Trust/PPO |
$19.58
|
| Rate for Payer: BCN Commercial |
$18.54
|
| Rate for Payer: Cash Price |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$20.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.19
|
| Rate for Payer: Healthscope Commercial |
$21.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.39
|
| Rate for Payer: Nomi Health Commercial |
$19.67
|
| Rate for Payer: PHP Commercial |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.59
|
| Rate for Payer: Priority Health HMO/PPO |
$20.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.11
|
| Rate for Payer: UHC Core |
$20.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.99
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.91
|
|
|
Service Code
|
NDC 55150018810
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.78 |
| Max. Negotiated Rate |
$14.32 |
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$6.36
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCN Commercial |
$12.37
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.73
|
| Rate for Payer: Cofinity Commercial |
$13.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.34
|
| Rate for Payer: Priority Health HMO/PPO |
$13.84
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.00
|
| Rate for Payer: UHC Core |
$13.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.98
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.93
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.05
|
|
|
Service Code
|
NDC 72485010710
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$20.44
|
| Rate for Payer: BCBS Trust/PPO |
$19.63
|
| Rate for Payer: BCN Commercial |
$18.59
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.24
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.44
|
| Rate for Payer: Nomi Health Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$20.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health HMO/PPO |
$20.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.16
|
| Rate for Payer: UHC Core |
$20.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.04
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.05
|
|
|
Service Code
|
NDC 72485010701
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.71 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$20.44
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.52
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$18.70
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.44
|
| Rate for Payer: Nomi Health Commercial |
$19.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$20.44
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health HMO/PPO |
$20.92
|
| Rate for Payer: Priority Health Medicare |
$6.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.16
|
| Rate for Payer: UHC Core |
$20.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.04
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.39
|
|
|
Service Code
|
NDC 61990061102
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$17.45 |
| Rate for Payer: Aetna Commercial |
$16.48
|
| Rate for Payer: BCBS Trust/PPO |
$15.83
|
| Rate for Payer: BCN Commercial |
$14.98
|
| Rate for Payer: Cash Price |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$16.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.51
|
| Rate for Payer: Healthscope Commercial |
$17.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.48
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: PHP Commercial |
$16.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health HMO/PPO |
$16.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.06
|
| Rate for Payer: UHC Core |
$16.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
NDC 43066000810
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.94
|
| Rate for Payer: BCBS Complete |
$8.88
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$17.26
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.55
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.88
|
|
|
Service Code
|
NDC 23155016641
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$15.19 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.28
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$4.22
|
| Rate for Payer: BCBS Trust/PPO |
$13.88
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: BCN Medicare Advantage |
$4.22
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.22
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$13.84
|
| Rate for Payer: PACE Senior Care Partners |
$4.01
|
| Rate for Payer: PACE SWMI |
$4.22
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health Medicare |
$4.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.22
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$4.22
|
| Rate for Payer: VA VA |
$4.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.38
|
|
|
Service Code
|
NDC 70860040010
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$24.64 |
| Rate for Payer: Aetna Commercial |
$23.27
|
| Rate for Payer: BCBS Trust/PPO |
$22.35
|
| Rate for Payer: BCN Commercial |
$21.16
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$23.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Healthscope Commercial |
$24.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Nomi Health Commercial |
$22.45
|
| Rate for Payer: PHP Commercial |
$23.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.80
|
| Rate for Payer: Priority Health HMO/PPO |
$23.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.09
|
| Rate for Payer: UHC Core |
$22.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.54
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
NDC 43066000801
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.94
|
| Rate for Payer: BCBS Complete |
$8.88
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$17.26
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.55
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.43
|
|
|
Service Code
|
NDC 60505616900
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.98 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: BCBS Trust/PPO |
$15.04
|
| Rate for Payer: BCN Commercial |
$14.24
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.05
|
|
|
Service Code
|
NDC 72485010710
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.71 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$20.44
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.52
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$19.77
|
| Rate for Payer: BCN Commercial |
$18.70
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.44
|
| Rate for Payer: Nomi Health Commercial |
$19.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$20.44
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health HMO/PPO |
$20.92
|
| Rate for Payer: Priority Health Medicare |
$6.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.16
|
| Rate for Payer: UHC Core |
$20.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.04
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.88
|
|
|
Service Code
|
NDC 23155016641
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$15.19 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.04
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$13.84
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.38
|
|
|
Service Code
|
NDC 70860040041
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$24.64 |
| Rate for Payer: Aetna Commercial |
$23.27
|
| Rate for Payer: BCBS Trust/PPO |
$22.35
|
| Rate for Payer: BCN Commercial |
$21.16
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$23.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Healthscope Commercial |
$24.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Nomi Health Commercial |
$22.45
|
| Rate for Payer: PHP Commercial |
$23.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.80
|
| Rate for Payer: Priority Health HMO/PPO |
$23.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.09
|
| Rate for Payer: UHC Core |
$22.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.54
|
|
|
TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.99
|
|
|
Service Code
|
NDC 39822100001
|
| Hospital Charge Code |
155937
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$21.59 |
| Rate for Payer: Aetna Commercial |
$20.39
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.50
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$19.72
|
| Rate for Payer: BCN Commercial |
$18.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.00
|
| Rate for Payer: Cash Price |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$20.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$21.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.39
|
| Rate for Payer: Nomi Health Commercial |
$19.67
|
| Rate for Payer: PACE Senior Care Partners |
$5.70
|
| Rate for Payer: PACE SWMI |
$6.00
|
| Rate for Payer: PHP Commercial |
$20.39
|
| Rate for Payer: PHP Medicare Advantage |
$6.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.59
|
| Rate for Payer: Priority Health HMO/PPO |
$20.87
|
| Rate for Payer: Priority Health Medicare |
$6.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$6.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.11
|
| Rate for Payer: UHC Core |
$20.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.00
|
| Rate for Payer: UHC Exchange |
$6.00
|
| Rate for Payer: UHC Medicare Advantage |
$6.00
|
| Rate for Payer: VA VA |
$6.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.99
|
|
