|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$357.20
|
|
|
Service Code
|
NDC 00603548221
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.17 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna American Axle |
$232.18
|
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.18
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Advantage |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health SBD |
$225.04
|
| Rate for Payer: UMR Bronson Commercial |
$157.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$2.46
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna American Axle |
$1.60
|
| Rate for Payer: Aetna Commercial |
$2.09
|
| Rate for Payer: Aetna Medicare |
$1.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.60
|
| Rate for Payer: BCBS Complete |
$0.98
|
| Rate for Payer: Cash Price |
$1.97
|
| Rate for Payer: Cofinity Advantage |
$1.72
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.97
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PHP Commercial |
$2.09
|
| Rate for Payer: Priority Health SBD |
$1.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.60
|
| Rate for Payer: UHC Core |
$1.28
|
| Rate for Payer: UHC Exchange |
$0.97
|
| Rate for Payer: UMR Bronson Commercial |
$0.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.17 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna American Axle |
$232.18
|
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.18
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Advantage |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health SBD |
$225.04
|
| Rate for Payer: UMR Bronson Commercial |
$157.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$51.70
|
|
|
Service Code
|
NDC 23155011001
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$46.53 |
| Rate for Payer: Aetna American Axle |
$33.60
|
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.60
|
| Rate for Payer: Cash Price |
$41.36
|
| Rate for Payer: Cofinity Advantage |
$36.19
|
| Rate for Payer: Cofinity Commercial |
$44.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.36
|
| Rate for Payer: Healthscope Commercial |
$46.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.77
|
| Rate for Payer: PHP Commercial |
$43.95
|
| Rate for Payer: Priority Health SBD |
$32.57
|
| Rate for Payer: UMR Bronson Commercial |
$22.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.77
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$245.10
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.69 |
| Max. Negotiated Rate |
$220.59 |
| Rate for Payer: Aetna American Axle |
$159.31
|
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: Aetna Medicare |
$122.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.31
|
| Rate for Payer: BCBS Complete |
$98.04
|
| Rate for Payer: Cash Price |
$196.08
|
| Rate for Payer: Cofinity Advantage |
$171.57
|
| Rate for Payer: Cofinity Commercial |
$210.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.08
|
| Rate for Payer: Healthscope Commercial |
$220.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.82
|
| Rate for Payer: PHP Commercial |
$208.34
|
| Rate for Payer: Priority Health SBD |
$154.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.31
|
| Rate for Payer: UHC Core |
$127.70
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UMR Bronson Commercial |
$90.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.82
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$51.70
|
|
|
Service Code
|
NDC 23155011001
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.13 |
| Max. Negotiated Rate |
$46.53 |
| Rate for Payer: Aetna American Axle |
$33.60
|
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: Aetna Medicare |
$25.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.60
|
| Rate for Payer: BCBS Complete |
$20.68
|
| Rate for Payer: Cash Price |
$41.36
|
| Rate for Payer: Cofinity Advantage |
$36.19
|
| Rate for Payer: Cofinity Commercial |
$44.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.36
|
| Rate for Payer: Healthscope Commercial |
$46.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.77
|
| Rate for Payer: PHP Commercial |
$43.95
|
| Rate for Payer: Priority Health SBD |
$32.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.60
|
| Rate for Payer: UHC Core |
$26.94
|
| Rate for Payer: UHC Exchange |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$19.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.77
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Advantage |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.38
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$155.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$354.85
|
|
|
Service Code
|
NDC 69292053001
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna American Axle |
$230.65
|
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.65
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Advantage |
$248.40
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: Priority Health SBD |
$223.56
|
| Rate for Payer: UMR Bronson Commercial |
$156.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$357.20
|
|
|
Service Code
|
NDC 00603548221
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.16 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna American Axle |
$232.18
|
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna Medicare |
$178.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.18
|
| Rate for Payer: BCBS Complete |
$142.88
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Advantage |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health SBD |
$225.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.18
|
| Rate for Payer: UHC Core |
$186.10
|
| Rate for Payer: UHC Exchange |
$140.38
|
| Rate for Payer: UMR Bronson Commercial |
$132.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$245.10
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.84 |
| Max. Negotiated Rate |
$220.59 |
| Rate for Payer: Aetna American Axle |
$159.31
|
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.31
|
| Rate for Payer: Cash Price |
$196.08
|
| Rate for Payer: Cofinity Advantage |
$171.57
|
| Rate for Payer: Cofinity Commercial |
$210.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.08
|
| Rate for Payer: Healthscope Commercial |
$220.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.82
|
| Rate for Payer: PHP Commercial |
$208.34
|
| Rate for Payer: Priority Health SBD |
$154.41
|
| Rate for Payer: UMR Bronson Commercial |
$107.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.82
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$2.46
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna American Axle |
$1.60
|
| Rate for Payer: Aetna Commercial |
$2.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.60
|
| Rate for Payer: Cash Price |
$1.97
|
| Rate for Payer: Cofinity Advantage |
$1.72
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.97
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PHP Commercial |
$2.09
|
| Rate for Payer: Priority Health SBD |
$1.55
|
| Rate for Payer: UMR Bronson Commercial |
$1.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$354.85
|
|
|
Service Code
|
NDC 69292053001
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.29 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna American Axle |
$230.65
|
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: Aetna Medicare |
$177.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.65
|
| Rate for Payer: BCBS Complete |
$141.94
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Advantage |
$248.40
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: Priority Health SBD |
$223.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.65
|
| Rate for Payer: UHC Core |
$184.88
|
| Rate for Payer: UHC Exchange |
$139.46
|
| Rate for Payer: UMR Bronson Commercial |
$131.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.16 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna American Axle |
$232.18
|
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna Medicare |
$178.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.18
|
| Rate for Payer: BCBS Complete |
$142.88
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Advantage |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health SBD |
$225.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.18
|
| Rate for Payer: UHC Core |
$186.10
|
| Rate for Payer: UHC Exchange |
$140.38
|
| Rate for Payer: UMR Bronson Commercial |
$132.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.43 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$176.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: BCBS Complete |
$141.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Advantage |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.38
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.12
|
| Rate for Payer: UHC Core |
$183.65
|
| Rate for Payer: UHC Exchange |
$138.53
|
| Rate for Payer: UMR Bronson Commercial |
$130.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.87
|
|
|
Service Code
|
HCPCS J1800
|
| Hospital Charge Code |
29335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$17.88 |
| Rate for Payer: Aetna American Axle |
$12.92
|
| Rate for Payer: Aetna American Axle |
$18.28
|
| Rate for Payer: Aetna Commercial |
$16.89
|
| Rate for Payer: Aetna Commercial |
$23.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.28
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cofinity Advantage |
$19.68
|
| Rate for Payer: Cofinity Advantage |
$13.91
|
| Rate for Payer: Cofinity Commercial |
$24.18
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$17.88
|
| Rate for Payer: Healthscope Commercial |
$25.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.09
|
| Rate for Payer: PHP Commercial |
$16.89
|
| Rate for Payer: PHP Commercial |
$23.90
|
| Rate for Payer: Priority Health SBD |
$17.72
|
| Rate for Payer: Priority Health SBD |
$12.52
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
| Rate for Payer: UMR Bronson Commercial |
$12.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.09
|
|
|
PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.87
|
|
|
Service Code
|
HCPCS J1800
|
| Hospital Charge Code |
29335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$18.13 |
| Rate for Payer: Aetna American Axle |
$12.92
|
| Rate for Payer: Aetna American Axle |
$18.28
|
| Rate for Payer: Aetna Commercial |
$16.89
|
| Rate for Payer: Aetna Commercial |
$23.90
|
| Rate for Payer: Aetna Medicare |
$9.94
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.28
|
| Rate for Payer: BCBS Complete |
$11.25
|
| Rate for Payer: BCBS Complete |
$7.95
|
| Rate for Payer: BCBS Trust/PPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$11.68
|
| Rate for Payer: BCN Commercial |
$11.68
|
| Rate for Payer: BCN Commercial |
$11.68
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$15.90
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cofinity Advantage |
$13.91
|
| Rate for Payer: Cofinity Advantage |
$19.68
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$24.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$17.88
|
| Rate for Payer: Healthscope Commercial |
$25.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.90
|
| Rate for Payer: PHP Commercial |
$16.89
|
| Rate for Payer: PHP Commercial |
$23.90
|
| Rate for Payer: Priority Health SBD |
$12.52
|
| Rate for Payer: Priority Health SBD |
$17.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.13
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: UHC Exchange |
$18.13
|
| Rate for Payer: UHC Exchange |
$18.13
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.09
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$16.71
|
|
|
Service Code
|
NDC 00121090840
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$15.04 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Cash Price |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.37
|
| Rate for Payer: Healthscope Commercial |
$15.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$16.71
|
|
|
Service Code
|
NDC 00121090805
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$15.04 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Cash Price |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.37
|
| Rate for Payer: Healthscope Commercial |
$15.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
OP
|
$1,069.25
|
|
|
Service Code
|
NDC 00054372763
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$395.62 |
| Max. Negotiated Rate |
$962.33 |
| Rate for Payer: Aetna American Axle |
$695.01
|
| Rate for Payer: Aetna Commercial |
$908.86
|
| Rate for Payer: Aetna Medicare |
$534.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.01
|
| Rate for Payer: BCBS Complete |
$427.70
|
| Rate for Payer: Cash Price |
$855.40
|
| Rate for Payer: Cofinity Advantage |
$748.48
|
| Rate for Payer: Cofinity Commercial |
$919.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.40
|
| Rate for Payer: Healthscope Commercial |
$962.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$855.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.94
|
| Rate for Payer: PHP Commercial |
$908.86
|
| Rate for Payer: Priority Health SBD |
$673.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.01
|
| Rate for Payer: UHC Core |
$557.08
|
| Rate for Payer: UHC Exchange |
$420.22
|
| Rate for Payer: UMR Bronson Commercial |
$395.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.94
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$1,069.25
|
|
|
Service Code
|
NDC 00054372763
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$470.47 |
| Max. Negotiated Rate |
$962.33 |
| Rate for Payer: Aetna American Axle |
$695.01
|
| Rate for Payer: Aetna Commercial |
$908.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.01
|
| Rate for Payer: Cash Price |
$855.40
|
| Rate for Payer: Cofinity Advantage |
$748.48
|
| Rate for Payer: Cofinity Commercial |
$919.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.40
|
| Rate for Payer: Healthscope Commercial |
$962.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.94
|
| Rate for Payer: PHP Commercial |
$908.86
|
| Rate for Payer: Priority Health SBD |
$673.63
|
| Rate for Payer: UMR Bronson Commercial |
$470.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.94
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
OP
|
$16.71
|
|
|
Service Code
|
NDC 00121090805
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$15.04 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$8.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: Cash Price |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.37
|
| Rate for Payer: Healthscope Commercial |
$15.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.86
|
| Rate for Payer: UHC Core |
$8.71
|
| Rate for Payer: UHC Exchange |
$6.57
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
OP
|
$16.71
|
|
|
Service Code
|
NDC 00121090840
|
| Hospital Charge Code |
6654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$15.04 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$8.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: Cash Price |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.37
|
| Rate for Payer: Healthscope Commercial |
$15.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.86
|
| Rate for Payer: UHC Core |
$8.71
|
| Rate for Payer: UHC Exchange |
$6.57
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$39.95
|
|
|
Service Code
|
NDC 23155011101
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna American Axle |
$25.97
|
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.97
|
| Rate for Payer: BCBS Complete |
$15.98
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Advantage |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.96
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: Priority Health SBD |
$25.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.97
|
| Rate for Payer: UHC Core |
$20.81
|
| Rate for Payer: UHC Exchange |
$15.70
|
| Rate for Payer: UMR Bronson Commercial |
$14.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$39.95
|
|
|
Service Code
|
NDC 23155011101
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna American Axle |
$25.97
|
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.97
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Advantage |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.96
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: Priority Health SBD |
$25.17
|
| Rate for Payer: UMR Bronson Commercial |
$17.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$298.45
|
|
|
Service Code
|
NDC 69238207801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.32 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna American Axle |
$193.99
|
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.99
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Advantage |
$208.91
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.84
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: Priority Health SBD |
$188.02
|
| Rate for Payer: UMR Bronson Commercial |
$131.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
