|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$463.60
|
|
|
Service Code
|
NDC 68084070901
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$301.34 |
| Max. Negotiated Rate |
$417.24 |
| Rate for Payer: Aetna Commercial |
$394.06
|
| Rate for Payer: BCBS Trust/PPO |
$378.44
|
| Rate for Payer: BCN Commercial |
$358.27
|
| Rate for Payer: Cash Price |
$370.88
|
| Rate for Payer: Cofinity Commercial |
$398.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.88
|
| Rate for Payer: Healthscope Commercial |
$417.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.06
|
| Rate for Payer: Nomi Health Commercial |
$380.15
|
| Rate for Payer: PHP Commercial |
$394.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.34
|
| Rate for Payer: Priority Health HMO/PPO |
$403.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.97
|
| Rate for Payer: UHC Core |
$387.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.70
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$102.90
|
|
|
Service Code
|
NDC 66993001968
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.89 |
| Max. Negotiated Rate |
$92.61 |
| Rate for Payer: Aetna Commercial |
$87.47
|
| Rate for Payer: BCBS Trust/PPO |
$84.00
|
| Rate for Payer: BCN Commercial |
$79.52
|
| Rate for Payer: Cash Price |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$88.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.32
|
| Rate for Payer: Healthscope Commercial |
$92.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.47
|
| Rate for Payer: Nomi Health Commercial |
$84.38
|
| Rate for Payer: PHP Commercial |
$87.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.89
|
| Rate for Payer: Priority Health HMO/PPO |
$89.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.55
|
| Rate for Payer: UHC Core |
$85.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.17
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$116.90
|
|
|
Service Code
|
NDC 00254100752
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: Aetna Medicare |
$30.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.53
|
| Rate for Payer: BCBS Complete |
$46.76
|
| Rate for Payer: BCBS MAPPO |
$29.23
|
| Rate for Payer: BCBS Trust/PPO |
$96.10
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$29.23
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.23
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.36
|
| Rate for Payer: Nomi Health Commercial |
$95.86
|
| Rate for Payer: PACE Senior Care Partners |
$27.76
|
| Rate for Payer: PACE SWMI |
$29.23
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: PHP Medicare Advantage |
$29.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.98
|
| Rate for Payer: Priority Health HMO/PPO |
$101.70
|
| Rate for Payer: Priority Health Medicare |
$29.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.32
|
| Rate for Payer: Railroad Medicare Medicare |
$29.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.23
|
| Rate for Payer: UHC Exchange |
$29.23
|
| Rate for Payer: UHC Medicare Advantage |
$29.23
|
| Rate for Payer: VA VA |
$29.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.67
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$116.90
|
|
|
Service Code
|
NDC 00254100752
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.98 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: BCBS Trust/PPO |
$95.43
|
| Rate for Payer: BCN Commercial |
$90.34
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.36
|
| Rate for Payer: Nomi Health Commercial |
$95.86
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.98
|
| Rate for Payer: Priority Health HMO/PPO |
$101.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.67
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.86 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna Medicare |
$17.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.87
|
| Rate for Payer: BCBS Complete |
$26.71
|
| Rate for Payer: BCBS MAPPO |
$16.70
|
| Rate for Payer: BCBS Trust/PPO |
$54.90
|
| Rate for Payer: BCN Commercial |
$51.92
|
| Rate for Payer: BCN Medicare Advantage |
$16.70
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.70
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: Nomi Health Commercial |
$54.76
|
| Rate for Payer: PACE Senior Care Partners |
$15.86
|
| Rate for Payer: PACE SWMI |
$16.70
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: PHP Medicare Advantage |
$16.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health HMO/PPO |
$58.10
|
| Rate for Payer: Priority Health Medicare |
$16.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.74
|
| Rate for Payer: Railroad Medicare Medicare |
$16.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.77
|
| Rate for Payer: UHC Core |
$55.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.70
|
| Rate for Payer: UHC Exchange |
$16.70
|
| Rate for Payer: UHC Medicare Advantage |
$16.70
|
| Rate for Payer: VA VA |
$16.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.41 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.61
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: Nomi Health Commercial |
$54.76
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health HMO/PPO |
$58.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.77
|
| Rate for Payer: UHC Core |
$55.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$102.90
|
|
|
Service Code
|
NDC 66993001968
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.44 |
| Max. Negotiated Rate |
$92.61 |
| Rate for Payer: Aetna Commercial |
$87.47
|
| Rate for Payer: Aetna Medicare |
$26.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.16
|
| Rate for Payer: BCBS Complete |
$41.16
|
| Rate for Payer: BCBS MAPPO |
$25.73
|
| Rate for Payer: BCBS Trust/PPO |
$84.59
|
| Rate for Payer: BCN Commercial |
$80.00
|
| Rate for Payer: BCN Medicare Advantage |
$25.73
|
| Rate for Payer: Cash Price |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$88.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.73
|
| Rate for Payer: Healthscope Commercial |
$92.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.47
|
| Rate for Payer: Nomi Health Commercial |
$84.38
|
| Rate for Payer: PACE Senior Care Partners |
$24.44
|
| Rate for Payer: PACE SWMI |
$25.73
|
| Rate for Payer: PHP Commercial |
$87.47
|
| Rate for Payer: PHP Medicare Advantage |
$25.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.89
|
| Rate for Payer: Priority Health HMO/PPO |
$89.52
|
| Rate for Payer: Priority Health Medicare |
$25.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.94
|
| Rate for Payer: Railroad Medicare Medicare |
$25.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.55
|
| Rate for Payer: UHC Core |
$85.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.73
|
| Rate for Payer: UHC Exchange |
$25.73
|
| Rate for Payer: UHC Medicare Advantage |
$25.73
|
| Rate for Payer: VA VA |
$25.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.17
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$36.70
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$33.03 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare |
$9.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.47
|
| Rate for Payer: BCBS Complete |
$14.68
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$30.17
|
| Rate for Payer: BCN Commercial |
$28.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.36
|
| Rate for Payer: Cofinity Commercial |
$31.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Nomi Health Commercial |
$30.09
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.86
|
| Rate for Payer: Priority Health HMO/PPO |
$31.93
|
| Rate for Payer: Priority Health Medicare |
$9.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.30
|
| Rate for Payer: UHC Core |
$30.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Exchange |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.18
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.52
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.97
|
|
|
Service Code
|
NDC 70069027101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: BCBS Trust/PPO |
$16.30
|
| Rate for Payer: BCN Commercial |
$15.43
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$16.38
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health HMO/PPO |
$17.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.57
|
| Rate for Payer: UHC Core |
$16.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.97
|
|
|
Service Code
|
NDC 70069027101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: Aetna Medicare |
$5.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.24
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.42
|
| Rate for Payer: BCN Commercial |
$15.53
|
| Rate for Payer: BCN Medicare Advantage |
$4.99
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$16.38
|
| Rate for Payer: PACE Senior Care Partners |
$4.74
|
| Rate for Payer: PACE SWMI |
$4.99
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: PHP Medicare Advantage |
$4.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health HMO/PPO |
$17.37
|
| Rate for Payer: Priority Health Medicare |
$5.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: Railroad Medicare Medicare |
$4.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.57
|
| Rate for Payer: UHC Core |
$16.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.99
|
| Rate for Payer: UHC Exchange |
$4.99
|
| Rate for Payer: UHC Medicare Advantage |
$4.99
|
| Rate for Payer: VA VA |
$4.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.97
|
|
|
Service Code
|
NDC 70069027105
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: Aetna Medicare |
$5.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.24
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.42
|
| Rate for Payer: BCN Commercial |
$15.53
|
| Rate for Payer: BCN Medicare Advantage |
$4.99
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$16.38
|
| Rate for Payer: PACE Senior Care Partners |
$4.74
|
| Rate for Payer: PACE SWMI |
$4.99
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: PHP Medicare Advantage |
$4.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health HMO/PPO |
$17.37
|
| Rate for Payer: Priority Health Medicare |
$5.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: Railroad Medicare Medicare |
$4.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.57
|
| Rate for Payer: UHC Core |
$16.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.99
|
| Rate for Payer: UHC Exchange |
$4.99
|
| Rate for Payer: UHC Medicare Advantage |
$4.99
|
| Rate for Payer: VA VA |
$4.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$36.70
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$33.03 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: BCBS Trust/PPO |
$29.96
|
| Rate for Payer: BCN Commercial |
$28.36
|
| Rate for Payer: Cash Price |
$29.36
|
| Rate for Payer: Cofinity Commercial |
$31.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.36
|
| Rate for Payer: Healthscope Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Nomi Health Commercial |
$30.09
|
| Rate for Payer: PHP Commercial |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.86
|
| Rate for Payer: Priority Health HMO/PPO |
$31.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.30
|
| Rate for Payer: UHC Core |
$30.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.52
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.97
|
|
|
Service Code
|
NDC 70069027105
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.98 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: BCBS Trust/PPO |
$16.30
|
| Rate for Payer: BCN Commercial |
$15.43
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$16.38
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health HMO/PPO |
$17.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.57
|
| Rate for Payer: UHC Core |
$16.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
VERAPAMIL 80 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 23155002601
|
| Hospital Charge Code |
8530
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.74 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: BCBS Trust/PPO |
$86.32
|
| Rate for Payer: BCN Commercial |
$81.72
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Nomi Health Commercial |
$86.72
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.74
|
| Rate for Payer: Priority Health HMO/PPO |
$92.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.06
|
| Rate for Payer: UHC Core |
$88.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
VERAPAMIL 80 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 23155002601
|
| Hospital Charge Code |
8530
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.12 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.05
|
| Rate for Payer: BCBS Complete |
$42.30
|
| Rate for Payer: BCBS MAPPO |
$26.44
|
| Rate for Payer: BCBS Trust/PPO |
$86.94
|
| Rate for Payer: BCN Commercial |
$82.22
|
| Rate for Payer: BCN Medicare Advantage |
$26.44
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.44
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Nomi Health Commercial |
$86.72
|
| Rate for Payer: PACE Senior Care Partners |
$25.12
|
| Rate for Payer: PACE SWMI |
$26.44
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: PHP Medicare Advantage |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.74
|
| Rate for Payer: Priority Health HMO/PPO |
$92.00
|
| Rate for Payer: Priority Health Medicare |
$26.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.85
|
| Rate for Payer: Railroad Medicare Medicare |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.06
|
| Rate for Payer: UHC Core |
$88.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.44
|
| Rate for Payer: UHC Exchange |
$26.44
|
| Rate for Payer: UHC Medicare Advantage |
$26.44
|
| Rate for Payer: VA VA |
$26.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.61 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna Medicare |
$52.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.64
|
| Rate for Payer: BCBS Complete |
$80.18
|
| Rate for Payer: BCBS MAPPO |
$50.11
|
| Rate for Payer: BCBS Trust/PPO |
$164.79
|
| Rate for Payer: BCN Commercial |
$155.85
|
| Rate for Payer: BCN Medicare Advantage |
$50.11
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.11
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: Nomi Health Commercial |
$164.37
|
| Rate for Payer: PACE Senior Care Partners |
$47.61
|
| Rate for Payer: PACE SWMI |
$50.11
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: PHP Medicare Advantage |
$50.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health HMO/PPO |
$174.39
|
| Rate for Payer: Priority Health Medicare |
$50.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.30
|
| Rate for Payer: Railroad Medicare Medicare |
$50.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.40
|
| Rate for Payer: UHC Core |
$167.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.11
|
| Rate for Payer: UHC Exchange |
$50.11
|
| Rate for Payer: UHC Medicare Advantage |
$50.11
|
| Rate for Payer: VA VA |
$50.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.29 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: BCBS Trust/PPO |
$163.63
|
| Rate for Payer: BCN Commercial |
$154.91
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: Nomi Health Commercial |
$164.37
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health HMO/PPO |
$174.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.40
|
| Rate for Payer: UHC Core |
$167.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.64
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: BCBS MAPPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.32
|
| Rate for Payer: BCN Commercial |
$4.08
|
| Rate for Payer: BCN Medicare Advantage |
$1.31
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.31
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: Nomi Health Commercial |
$4.30
|
| Rate for Payer: PACE Senior Care Partners |
$1.25
|
| Rate for Payer: PACE SWMI |
$1.31
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: PHP Medicare Advantage |
$1.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health HMO/PPO |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$1.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.62
|
| Rate for Payer: UHC Core |
$4.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.31
|
| Rate for Payer: UHC Exchange |
$1.31
|
| Rate for Payer: UHC Medicare Advantage |
$1.31
|
| Rate for Payer: VA VA |
$1.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$341.02 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: BCBS Trust/PPO |
$428.26
|
| Rate for Payer: BCN Commercial |
$405.44
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: Nomi Health Commercial |
$430.20
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.02
|
| Rate for Payer: Priority Health HMO/PPO |
$456.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.68
|
| Rate for Payer: UHC Core |
$438.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: BCBS Trust/PPO |
$4.29
|
| Rate for Payer: BCN Commercial |
$4.06
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: Nomi Health Commercial |
$4.30
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health HMO/PPO |
$4.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.62
|
| Rate for Payer: UHC Core |
$4.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.60 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna Medicare |
$136.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.95
|
| Rate for Payer: BCBS Complete |
$209.86
|
| Rate for Payer: BCBS MAPPO |
$131.16
|
| Rate for Payer: BCBS Trust/PPO |
$431.31
|
| Rate for Payer: BCN Commercial |
$407.91
|
| Rate for Payer: BCN Medicare Advantage |
$131.16
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.16
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: Nomi Health Commercial |
$430.20
|
| Rate for Payer: PACE Senior Care Partners |
$124.60
|
| Rate for Payer: PACE SWMI |
$131.16
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: PHP Medicare Advantage |
$131.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.02
|
| Rate for Payer: Priority Health HMO/PPO |
$456.44
|
| Rate for Payer: Priority Health Medicare |
$132.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.51
|
| Rate for Payer: Railroad Medicare Medicare |
$131.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.68
|
| Rate for Payer: UHC Core |
$438.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.16
|
| Rate for Payer: UHC Exchange |
$131.16
|
| Rate for Payer: UHC Medicare Advantage |
$131.16
|
| Rate for Payer: VA VA |
$131.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$432.40
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.69 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: Aetna Medicare |
$112.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$135.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$135.12
|
| Rate for Payer: BCBS Complete |
$172.96
|
| Rate for Payer: BCBS MAPPO |
$108.10
|
| Rate for Payer: BCBS Trust/PPO |
$355.48
|
| Rate for Payer: BCN Commercial |
$336.19
|
| Rate for Payer: BCN Medicare Advantage |
$108.10
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.10
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: Nomi Health Commercial |
$354.57
|
| Rate for Payer: PACE Senior Care Partners |
$102.69
|
| Rate for Payer: PACE SWMI |
$108.10
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: PHP Medicare Advantage |
$108.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.06
|
| Rate for Payer: Priority Health HMO/PPO |
$376.19
|
| Rate for Payer: Priority Health Medicare |
$109.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.71
|
| Rate for Payer: Railroad Medicare Medicare |
$108.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.51
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.10
|
| Rate for Payer: UHC Exchange |
$108.10
|
| Rate for Payer: UHC Medicare Advantage |
$108.10
|
| Rate for Payer: VA VA |
$108.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$432.40
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$281.06 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: BCBS Trust/PPO |
$352.97
|
| Rate for Payer: BCN Commercial |
$334.16
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: Nomi Health Commercial |
$354.57
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.06
|
| Rate for Payer: Priority Health HMO/PPO |
$376.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.51
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$303.15
|
|
|
Service Code
|
NDC 68462026001
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$197.05 |
| Max. Negotiated Rate |
$272.83 |
| Rate for Payer: Aetna Commercial |
$257.68
|
| Rate for Payer: BCBS Trust/PPO |
$247.46
|
| Rate for Payer: BCN Commercial |
$234.27
|
| Rate for Payer: Cash Price |
$242.52
|
| Rate for Payer: Cofinity Commercial |
$260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.52
|
| Rate for Payer: Healthscope Commercial |
$272.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.68
|
| Rate for Payer: Nomi Health Commercial |
$248.58
|
| Rate for Payer: PHP Commercial |
$257.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.05
|
| Rate for Payer: Priority Health HMO/PPO |
$263.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.77
|
| Rate for Payer: UHC Core |
$253.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.36
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$303.15
|
|
|
Service Code
|
NDC 68462026001
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$272.83 |
| Rate for Payer: Aetna Commercial |
$257.68
|
| Rate for Payer: Aetna Medicare |
$78.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.73
|
| Rate for Payer: BCBS Complete |
$121.26
|
| Rate for Payer: BCBS MAPPO |
$75.79
|
| Rate for Payer: BCBS Trust/PPO |
$249.22
|
| Rate for Payer: BCN Commercial |
$235.70
|
| Rate for Payer: BCN Medicare Advantage |
$75.79
|
| Rate for Payer: Cash Price |
$242.52
|
| Rate for Payer: Cofinity Commercial |
$260.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.79
|
| Rate for Payer: Healthscope Commercial |
$272.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.68
|
| Rate for Payer: Nomi Health Commercial |
$248.58
|
| Rate for Payer: PACE Senior Care Partners |
$72.00
|
| Rate for Payer: PACE SWMI |
$75.79
|
| Rate for Payer: PHP Commercial |
$257.68
|
| Rate for Payer: PHP Medicare Advantage |
$75.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.05
|
| Rate for Payer: Priority Health HMO/PPO |
$263.74
|
| Rate for Payer: Priority Health Medicare |
$76.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.11
|
| Rate for Payer: Railroad Medicare Medicare |
$75.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.77
|
| Rate for Payer: UHC Core |
$253.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.79
|
| Rate for Payer: UHC Exchange |
$75.79
|
| Rate for Payer: UHC Medicare Advantage |
$75.79
|
| Rate for Payer: VA VA |
$75.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.36
|
|
