|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$44.98
|
|
|
Service Code
|
NDC 47335-932-40
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$40.48 |
| Rate for Payer: Aetna American Axle |
$29.24
|
| Rate for Payer: Aetna Commercial |
$38.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.24
|
| Rate for Payer: Cash Price |
$35.98
|
| Rate for Payer: Cofinity Commercial |
$31.49
|
| Rate for Payer: Cofinity Commercial |
$38.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.98
|
| Rate for Payer: Healthscope Commercial |
$40.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.23
|
| Rate for Payer: PHP Commercial |
$38.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.49
|
| Rate for Payer: Priority Health SBD |
$28.34
|
| Rate for Payer: UMR Bronson Commercial |
$19.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.74
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$51.14
|
|
|
Service Code
|
NDC 55390-039-10
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna American Axle |
$33.24
|
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: Cash Price |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$35.80
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$46.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.47
|
| Rate for Payer: PHP Commercial |
$43.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.80
|
| Rate for Payer: Priority Health SBD |
$32.22
|
| Rate for Payer: UMR Bronson Commercial |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.36
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$54.39
|
|
|
Service Code
|
NDC 0409-1634-01
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.93 |
| Max. Negotiated Rate |
$48.95 |
| Rate for Payer: Aetna American Axle |
$35.35
|
| Rate for Payer: Aetna Commercial |
$46.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.35
|
| Rate for Payer: Cash Price |
$43.51
|
| Rate for Payer: Cofinity Commercial |
$38.07
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.51
|
| Rate for Payer: Healthscope Commercial |
$48.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.23
|
| Rate for Payer: PHP Commercial |
$46.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.07
|
| Rate for Payer: Priority Health SBD |
$34.27
|
| Rate for Payer: UMR Bronson Commercial |
$23.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.79
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616-932-40
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.31
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$38.35
|
|
|
Service Code
|
NDC 0143-9232-10
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$34.52 |
| Rate for Payer: Aetna American Axle |
$24.93
|
| Rate for Payer: Aetna Commercial |
$32.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.93
|
| Rate for Payer: Cash Price |
$30.68
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$32.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.68
|
| Rate for Payer: Healthscope Commercial |
$34.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.60
|
| Rate for Payer: PHP Commercial |
$32.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health SBD |
$24.16
|
| Rate for Payer: UMR Bronson Commercial |
$16.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.76
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$40.98
|
|
|
Service Code
|
NDC 67457-475-20
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$36.88 |
| Rate for Payer: Aetna American Axle |
$26.64
|
| Rate for Payer: Aetna Commercial |
$34.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.64
|
| Rate for Payer: Cash Price |
$32.78
|
| Rate for Payer: Cofinity Commercial |
$28.69
|
| Rate for Payer: Cofinity Commercial |
$35.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.78
|
| Rate for Payer: Healthscope Commercial |
$36.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.83
|
| Rate for Payer: PHP Commercial |
$34.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.69
|
| Rate for Payer: Priority Health SBD |
$25.82
|
| Rate for Payer: UMR Bronson Commercial |
$18.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.74
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$44.98
|
|
|
Service Code
|
NDC 47335-932-44
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$40.48 |
| Rate for Payer: Aetna American Axle |
$29.24
|
| Rate for Payer: Aetna Commercial |
$38.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.24
|
| Rate for Payer: Cash Price |
$35.98
|
| Rate for Payer: Cofinity Commercial |
$31.49
|
| Rate for Payer: Cofinity Commercial |
$38.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.98
|
| Rate for Payer: Healthscope Commercial |
$40.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.23
|
| Rate for Payer: PHP Commercial |
$38.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.49
|
| Rate for Payer: Priority Health SBD |
$28.34
|
| Rate for Payer: UMR Bronson Commercial |
$19.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.74
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$34.17
|
|
|
Service Code
|
NDC 0409-1634-85
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.04
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.92
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616-932-44
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.31
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$38.35
|
|
|
Service Code
|
NDC 0143-9232-01
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$34.52 |
| Rate for Payer: Aetna American Axle |
$24.93
|
| Rate for Payer: Aetna Commercial |
$32.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.93
|
| Rate for Payer: Cash Price |
$30.68
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$32.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.68
|
| Rate for Payer: Healthscope Commercial |
$34.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.60
|
| Rate for Payer: PHP Commercial |
$32.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health SBD |
$24.16
|
| Rate for Payer: UMR Bronson Commercial |
$16.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.76
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$20.49
|
|
|
Service Code
|
NDC 55150-236-21
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.42
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.34
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$49.88
|
|
|
Service Code
|
NDC 63323-782-20
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.40
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.92
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616-932-44
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.31
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
IP
|
$51.14
|
|
|
Service Code
|
NDC 55390-039-10
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna American Axle |
$33.24
|
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: Cash Price |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Commercial |
$35.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$46.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.47
|
| Rate for Payer: PHP Commercial |
$43.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.80
|
| Rate for Payer: Priority Health SBD |
$32.22
|
| Rate for Payer: UMR Bronson Commercial |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.36
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616-932-40
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.31
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$22,533.11
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9,914.57 |
| Max. Negotiated Rate |
$20,279.80 |
| Rate for Payer: Aetna American Axle |
$14,646.52
|
| Rate for Payer: Aetna Commercial |
$19,153.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,646.52
|
| Rate for Payer: Cash Price |
$18,026.49
|
| Rate for Payer: Cofinity Commercial |
$15,773.18
|
| Rate for Payer: Cofinity Commercial |
$19,378.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,026.49
|
| Rate for Payer: Healthscope Commercial |
$20,279.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,773.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,899.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19,153.14
|
| Rate for Payer: PHP Commercial |
$19,153.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,773.18
|
| Rate for Payer: Priority Health SBD |
$14,195.86
|
| Rate for Payer: UMR Bronson Commercial |
$9,914.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,899.83
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
OP
|
$22,533.11
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$20,279.80 |
| Rate for Payer: Aetna American Axle |
$14,646.52
|
| Rate for Payer: Aetna Commercial |
$19,153.14
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,646.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.58
|
| Rate for Payer: BCBS Complete |
$12.67
|
| Rate for Payer: BCBS MAPPO |
$22.06
|
| Rate for Payer: BCBS Trust/PPO |
$71.27
|
| Rate for Payer: BCN Medicare Advantage |
$22.06
|
| Rate for Payer: Cash Price |
$18,026.49
|
| Rate for Payer: Cash Price |
$18,026.49
|
| Rate for Payer: Cofinity Commercial |
$15,773.18
|
| Rate for Payer: Cofinity Commercial |
$19,378.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,026.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.06
|
| Rate for Payer: Healthscope Commercial |
$20,279.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,773.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,899.83
|
| Rate for Payer: Mclaren Medicaid |
$12.07
|
| Rate for Payer: Mclaren Medicare |
$22.06
|
| Rate for Payer: Meridian Medicaid |
$12.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19,153.14
|
| Rate for Payer: PACE Medicare |
$20.96
|
| Rate for Payer: PACE SWMI |
$22.06
|
| Rate for Payer: PHP Commercial |
$19,153.14
|
| Rate for Payer: PHP Medicare Advantage |
$22.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,773.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.49
|
| Rate for Payer: Priority Health Medicare |
$22.06
|
| Rate for Payer: Priority Health Narrow Network |
$52.39
|
| Rate for Payer: Priority Health SBD |
$14,195.86
|
| Rate for Payer: Railroad Medicare Medicare |
$22.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.06
|
| Rate for Payer: UHC Medicare Advantage |
$22.72
|
| Rate for Payer: UMR Bronson Commercial |
$8,337.25
|
| Rate for Payer: VA VA |
$22.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,899.83
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
IP
|
$50,768.12
|
|
|
Service Code
|
MS-DRG 263
|
| Min. Negotiated Rate |
$21,169.27 |
| Max. Negotiated Rate |
$50,768.12 |
| Rate for Payer: Aetna Medicare |
$23,174.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,854.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,854.30
|
| Rate for Payer: BCBS MAPPO |
$22,283.44
|
| Rate for Payer: BCBS Trust/PPO |
$50,768.12
|
| Rate for Payer: BCN Medicare Advantage |
$22,283.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,283.44
|
| Rate for Payer: Mclaren Medicare |
$22,283.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23,397.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,625.96
|
| Rate for Payer: PACE Medicare |
$21,169.27
|
| Rate for Payer: PACE SWMI |
$22,283.44
|
| Rate for Payer: PHP Medicare Advantage |
$22,283.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40,541.39
|
| Rate for Payer: Priority Health Medicare |
$22,283.44
|
| Rate for Payer: Priority Health Narrow Network |
$32,433.11
|
| Rate for Payer: Railroad Medicare Medicare |
$22,283.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43,095.60
|
| Rate for Payer: UHC Core |
$35,337.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,283.44
|
| Rate for Payer: UHC Exchange |
$28,093.79
|
| Rate for Payer: UHC Medicare Advantage |
$22,951.94
|
| Rate for Payer: VA VA |
$22,283.44
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
IP
|
$470.68
|
|
|
Service Code
|
NDC 0074-0576-11
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$207.10 |
| Max. Negotiated Rate |
$423.61 |
| Rate for Payer: Aetna American Axle |
$305.94
|
| Rate for Payer: Aetna Commercial |
$400.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.94
|
| Rate for Payer: Cash Price |
$376.54
|
| Rate for Payer: Cofinity Commercial |
$329.48
|
| Rate for Payer: Cofinity Commercial |
$404.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.54
|
| Rate for Payer: Healthscope Commercial |
$423.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$400.08
|
| Rate for Payer: PHP Commercial |
$400.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.48
|
| Rate for Payer: Priority Health SBD |
$296.53
|
| Rate for Payer: UMR Bronson Commercial |
$207.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.01
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
IP
|
$13,179.89
|
|
|
Service Code
|
NDC 0074-0576-30
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,799.15 |
| Max. Negotiated Rate |
$11,861.90 |
| Rate for Payer: Aetna American Axle |
$8,566.93
|
| Rate for Payer: Aetna Commercial |
$11,202.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,566.93
|
| Rate for Payer: Cash Price |
$10,543.91
|
| Rate for Payer: Cofinity Commercial |
$11,334.71
|
| Rate for Payer: Cofinity Commercial |
$9,225.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,543.91
|
| Rate for Payer: Healthscope Commercial |
$11,861.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,225.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,884.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,202.91
|
| Rate for Payer: PHP Commercial |
$11,202.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,225.92
|
| Rate for Payer: Priority Health SBD |
$8,303.33
|
| Rate for Payer: UMR Bronson Commercial |
$5,799.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,884.92
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
IP
|
$94.13
|
|
|
Service Code
|
NDC 0074-0561-11
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.42 |
| Max. Negotiated Rate |
$84.72 |
| Rate for Payer: Aetna American Axle |
$61.18
|
| Rate for Payer: Aetna Commercial |
$80.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.18
|
| Rate for Payer: Cash Price |
$75.30
|
| Rate for Payer: Cofinity Commercial |
$65.89
|
| Rate for Payer: Cofinity Commercial |
$80.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.30
|
| Rate for Payer: Healthscope Commercial |
$84.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.01
|
| Rate for Payer: PHP Commercial |
$80.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.89
|
| Rate for Payer: Priority Health SBD |
$59.30
|
| Rate for Payer: UMR Bronson Commercial |
$41.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.60
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
IP
|
$659.00
|
|
|
Service Code
|
NDC 0074-0561-14
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$289.96 |
| Max. Negotiated Rate |
$593.10 |
| Rate for Payer: Aetna American Axle |
$428.35
|
| Rate for Payer: Aetna Commercial |
$560.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.35
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Cofinity Commercial |
$461.30
|
| Rate for Payer: Cofinity Commercial |
$566.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.20
|
| Rate for Payer: Healthscope Commercial |
$593.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$461.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$494.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$560.15
|
| Rate for Payer: PHP Commercial |
$560.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.30
|
| Rate for Payer: Priority Health SBD |
$415.17
|
| Rate for Payer: UMR Bronson Commercial |
$289.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$494.25
|
|
|
VENETOCLAX 50 MG TABLET
|
Facility
IP
|
$235.36
|
|
|
Service Code
|
NDC 0074-0566-11
|
| Hospital Charge Code |
178562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$103.56 |
| Max. Negotiated Rate |
$211.82 |
| Rate for Payer: Aetna American Axle |
$152.98
|
| Rate for Payer: Aetna Commercial |
$200.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.98
|
| Rate for Payer: Cash Price |
$188.29
|
| Rate for Payer: Cofinity Commercial |
$164.75
|
| Rate for Payer: Cofinity Commercial |
$202.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.29
|
| Rate for Payer: Healthscope Commercial |
$211.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.06
|
| Rate for Payer: PHP Commercial |
$200.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.75
|
| Rate for Payer: Priority Health SBD |
$148.28
|
| Rate for Payer: UMR Bronson Commercial |
$103.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.52
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
IP
|
$293.55
|
|
|
Service Code
|
NDC 68382-019-01
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.16 |
| Max. Negotiated Rate |
$264.20 |
| Rate for Payer: Aetna American Axle |
$190.81
|
| Rate for Payer: Aetna Commercial |
$249.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.81
|
| Rate for Payer: Cash Price |
$234.84
|
| Rate for Payer: Cofinity Commercial |
$205.48
|
| Rate for Payer: Cofinity Commercial |
$252.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.84
|
| Rate for Payer: Healthscope Commercial |
$264.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.52
|
| Rate for Payer: PHP Commercial |
$249.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.48
|
| Rate for Payer: Priority Health SBD |
$184.94
|
| Rate for Payer: UMR Bronson Commercial |
$129.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.16
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
IP
|
$2.65
|
|
|
Service Code
|
NDC 51079-480-01
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$1.86
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$1.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.25
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.86
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
