|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$353.97
|
|
|
Service Code
|
NDC 71921-173-09
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.75 |
| Max. Negotiated Rate |
$318.57 |
| Rate for Payer: Aetna American Axle |
$230.08
|
| Rate for Payer: Aetna Commercial |
$300.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.08
|
| Rate for Payer: Cash Price |
$283.18
|
| Rate for Payer: Cofinity Commercial |
$247.78
|
| Rate for Payer: Cofinity Commercial |
$304.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.18
|
| Rate for Payer: Healthscope Commercial |
$318.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.87
|
| Rate for Payer: PHP Commercial |
$300.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.78
|
| Rate for Payer: Priority Health SBD |
$223.00
|
| Rate for Payer: UMR Bronson Commercial |
$155.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.48
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$406.13
|
|
|
Service Code
|
NDC 13668-019-90
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.70 |
| Max. Negotiated Rate |
$365.52 |
| Rate for Payer: Aetna American Axle |
$263.98
|
| Rate for Payer: Aetna Commercial |
$345.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.98
|
| Rate for Payer: Cash Price |
$324.90
|
| Rate for Payer: Cofinity Commercial |
$284.29
|
| Rate for Payer: Cofinity Commercial |
$349.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.90
|
| Rate for Payer: Healthscope Commercial |
$365.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.21
|
| Rate for Payer: PHP Commercial |
$345.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.29
|
| Rate for Payer: Priority Health SBD |
$255.86
|
| Rate for Payer: UMR Bronson Commercial |
$178.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.60
|
|
|
VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,859.63
|
|
|
Service Code
|
CPT 36500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.53 |
| Max. Negotiated Rate |
$1,859.63 |
| Rate for Payer: BCBS Trust/PPO |
$1,859.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.98
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$174.53
|
|
|
VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA
|
Facility
|
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 69424
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$59.59 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,042.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.55
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$59.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$66.78
|
|
|
Service Code
|
NDC 0173-0682-24
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: BCBS Complete |
$26.71
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.76
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.75
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UMR Bronson Commercial |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.08
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$66.78
|
|
|
Service Code
|
NDC 0173-0682-24
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.38 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.76
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.75
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UMR Bronson Commercial |
$29.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.08
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$42,714.27
|
|
|
Service Code
|
MS-DRG 032
|
| Min. Negotiated Rate |
$16,254.12 |
| Max. Negotiated Rate |
$42,714.27 |
| Rate for Payer: Aetna Medicare |
$17,793.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,387.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,387.00
|
| Rate for Payer: BCBS MAPPO |
$17,109.60
|
| Rate for Payer: BCBS Trust/PPO |
$42,714.27
|
| Rate for Payer: BCN Medicare Advantage |
$17,109.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,109.60
|
| Rate for Payer: Mclaren Medicare |
$17,109.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,965.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,676.04
|
| Rate for Payer: PACE Medicare |
$16,254.12
|
| Rate for Payer: PACE SWMI |
$17,109.60
|
| Rate for Payer: PHP Medicare Advantage |
$17,109.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,906.86
|
| Rate for Payer: Priority Health Medicare |
$17,109.60
|
| Rate for Payer: Priority Health Narrow Network |
$24,725.49
|
| Rate for Payer: Railroad Medicare Medicare |
$17,109.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,854.07
|
| Rate for Payer: UHC Core |
$26,939.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,109.60
|
| Rate for Payer: UHC Exchange |
$21,417.39
|
| Rate for Payer: UHC Medicare Advantage |
$17,622.89
|
| Rate for Payer: VA VA |
$17,109.60
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$99,561.10
|
|
|
Service Code
|
MS-DRG 031
|
| Min. Negotiated Rate |
$30,623.27 |
| Max. Negotiated Rate |
$99,561.10 |
| Rate for Payer: Aetna Medicare |
$33,524.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,293.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,293.78
|
| Rate for Payer: BCBS MAPPO |
$32,235.02
|
| Rate for Payer: BCBS Trust/PPO |
$99,561.10
|
| Rate for Payer: BCN Medicare Advantage |
$32,235.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,235.02
|
| Rate for Payer: Mclaren Medicare |
$32,235.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33,846.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,070.27
|
| Rate for Payer: PACE Medicare |
$30,623.27
|
| Rate for Payer: PACE SWMI |
$32,235.02
|
| Rate for Payer: PHP Medicare Advantage |
$32,235.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59,072.88
|
| Rate for Payer: Priority Health Medicare |
$32,235.02
|
| Rate for Payer: Priority Health Narrow Network |
$47,258.30
|
| Rate for Payer: Railroad Medicare Medicare |
$32,235.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62,794.62
|
| Rate for Payer: UHC Core |
$51,490.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,235.02
|
| Rate for Payer: UHC Exchange |
$40,935.47
|
| Rate for Payer: UHC Medicare Advantage |
$33,202.07
|
| Rate for Payer: VA VA |
$32,235.02
|
|
|
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$39,055.49
|
|
|
Service Code
|
MS-DRG 033
|
| Min. Negotiated Rate |
$12,367.54 |
| Max. Negotiated Rate |
$39,055.49 |
| Rate for Payer: Aetna Medicare |
$13,539.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,273.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,273.08
|
| Rate for Payer: BCBS MAPPO |
$13,018.46
|
| Rate for Payer: BCBS Trust/PPO |
$39,055.49
|
| Rate for Payer: BCN Medicare Advantage |
$13,018.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,018.46
|
| Rate for Payer: Mclaren Medicare |
$13,018.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,669.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,971.23
|
| Rate for Payer: PACE Medicare |
$12,367.54
|
| Rate for Payer: PACE SWMI |
$13,018.46
|
| Rate for Payer: PHP Medicare Advantage |
$13,018.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,288.49
|
| Rate for Payer: Priority Health Medicare |
$13,018.46
|
| Rate for Payer: Priority Health Narrow Network |
$18,630.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13,018.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,755.72
|
| Rate for Payer: UHC Core |
$20,299.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,018.46
|
| Rate for Payer: UHC Exchange |
$16,138.12
|
| Rate for Payer: UHC Medicare Advantage |
$13,409.01
|
| Rate for Payer: VA VA |
$13,018.46
|
|
|
VERAPAMIL 0.25 MG/ML IN HEPARINIZED SALINE 2 UNITS/ML
|
Facility
|
IP
|
$175.45
|
|
|
Service Code
|
NDC 9900-0010-92
|
| Hospital Charge Code |
300101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$157.90 |
| Rate for Payer: Aetna American Axle |
$114.04
|
| Rate for Payer: Aetna Commercial |
$149.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.04
|
| Rate for Payer: Cash Price |
$140.36
|
| Rate for Payer: Cofinity Commercial |
$122.82
|
| Rate for Payer: Cofinity Commercial |
$150.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.36
|
| Rate for Payer: Healthscope Commercial |
$157.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$149.13
|
| Rate for Payer: PHP Commercial |
$149.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.82
|
| Rate for Payer: Priority Health SBD |
$110.53
|
| Rate for Payer: UMR Bronson Commercial |
$77.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.59
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.77
|
|
|
Service Code
|
NDC 43066-035-05
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.35
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.94
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.64
|
|
|
Service Code
|
NDC 70069-272-01
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.75
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$8.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.91
|
|
|
Service Code
|
NDC 55150-343-05
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$16.12 |
| Rate for Payer: Aetna American Axle |
$11.64
|
| Rate for Payer: Aetna Commercial |
$15.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.64
|
| Rate for Payer: Cash Price |
$14.33
|
| Rate for Payer: Cofinity Commercial |
$12.54
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.33
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.22
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.54
|
| Rate for Payer: Priority Health SBD |
$11.28
|
| Rate for Payer: UMR Bronson Commercial |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.43
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.77
|
|
|
Service Code
|
NDC 43066-035-01
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.35
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.94
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
NDC 70121-1586-3
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna American Axle |
$14.43
|
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.43
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.87
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.54
|
| Rate for Payer: Priority Health SBD |
$13.99
|
| Rate for Payer: UMR Bronson Commercial |
$9.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$37.25
|
|
|
Service Code
|
NDC 51754-0203-1
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$26.08
|
| Rate for Payer: Cofinity Commercial |
$32.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.08
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.23
|
|
|
Service Code
|
NDC 0409-1144-62
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Aetna American Axle |
$15.10
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.10
|
| Rate for Payer: Cash Price |
$18.58
|
| Rate for Payer: Cofinity Commercial |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$20.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.75
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.26
|
| Rate for Payer: Priority Health SBD |
$14.63
|
| Rate for Payer: UMR Bronson Commercial |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.42
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.48
|
|
|
Service Code
|
NDC 70756-605-25
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$19.33 |
| Rate for Payer: Aetna American Axle |
$13.96
|
| Rate for Payer: Aetna Commercial |
$18.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.96
|
| Rate for Payer: Cash Price |
$17.18
|
| Rate for Payer: Cofinity Commercial |
$15.04
|
| Rate for Payer: Cofinity Commercial |
$18.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.18
|
| Rate for Payer: Healthscope Commercial |
$19.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.26
|
| Rate for Payer: PHP Commercial |
$18.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health SBD |
$13.53
|
| Rate for Payer: UMR Bronson Commercial |
$9.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.11
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$32.47
|
|
|
Service Code
|
NDC 72485-109-01
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna American Axle |
$21.11
|
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.60
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.73
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$107.64
|
|
|
Service Code
|
NDC 0409-1144-01
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna American Axle |
$69.97
|
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$75.35
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.49
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.35
|
| Rate for Payer: Priority Health SBD |
$67.81
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.96
|
|
|
Service Code
|
NDC 70710-1644-5
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.77
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.07
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.17
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.47
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.64
|
|
|
Service Code
|
NDC 70069-272-05
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.75
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$8.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.91
|
|
|
Service Code
|
NDC 55150-343-01
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$16.12 |
| Rate for Payer: Aetna American Axle |
$11.64
|
| Rate for Payer: Aetna Commercial |
$15.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.64
|
| Rate for Payer: Cash Price |
$14.33
|
| Rate for Payer: Cofinity Commercial |
$12.54
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.33
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.22
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.54
|
| Rate for Payer: Priority Health SBD |
$11.28
|
| Rate for Payer: UMR Bronson Commercial |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.43
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.66
|
|
|
Service Code
|
NDC 70756-605-82
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$19.49 |
| Rate for Payer: Aetna American Axle |
$14.08
|
| Rate for Payer: Aetna Commercial |
$18.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.08
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cofinity Commercial |
$15.16
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.33
|
| Rate for Payer: Healthscope Commercial |
$19.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.41
|
| Rate for Payer: PHP Commercial |
$18.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.16
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$9.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.24
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.96
|
|
|
Service Code
|
NDC 70710-1644-1
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.77
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.07
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.17
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.47
|
|
