|
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
|
$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
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$439.45
|
|
|
Service Code
|
NDC 00115166001
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna Medicare |
$219.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: BCBS Complete |
$175.78
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Advantage |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.64
|
| Rate for Payer: UHC Core |
$228.95
|
| Rate for Payer: UHC Exchange |
$172.70
|
| Rate for Payer: UMR Bronson Commercial |
$162.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$298.45
|
|
|
Service Code
|
NDC 69238207801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.43 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna American Axle |
$193.99
|
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna Medicare |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.99
|
| Rate for Payer: BCBS Complete |
$119.38
|
| 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: MI Amish Medical Board Commercial |
$238.76
|
| 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: UHC All Payor (Choice/PPO) |
$193.99
|
| Rate for Payer: UHC Core |
$155.49
|
| Rate for Payer: UHC Exchange |
$117.29
|
| Rate for Payer: UMR Bronson Commercial |
$110.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$437.10
|
|
|
Service Code
|
NDC 00603548321
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.73 |
| Max. Negotiated Rate |
$393.39 |
| Rate for Payer: Aetna American Axle |
$284.12
|
| Rate for Payer: Aetna Commercial |
$371.54
|
| Rate for Payer: Aetna Medicare |
$218.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.12
|
| Rate for Payer: BCBS Complete |
$174.84
|
| Rate for Payer: Cash Price |
$349.68
|
| Rate for Payer: Cofinity Advantage |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$375.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.68
|
| Rate for Payer: Healthscope Commercial |
$393.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.82
|
| Rate for Payer: PHP Commercial |
$371.54
|
| Rate for Payer: Priority Health SBD |
$275.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.12
|
| Rate for Payer: UHC Core |
$227.73
|
| Rate for Payer: UHC Exchange |
$171.78
|
| Rate for Payer: UMR Bronson Commercial |
$161.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.82
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 00115166101
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$99.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
IP
|
$426.55
|
|
|
Service Code
|
NDC 00591555601
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$187.68 |
| Max. Negotiated Rate |
$383.89 |
| Rate for Payer: Aetna American Axle |
$277.26
|
| Rate for Payer: Aetna Commercial |
$362.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.26
|
| Rate for Payer: Cash Price |
$341.24
|
| Rate for Payer: Cofinity Advantage |
$298.58
|
| Rate for Payer: Cofinity Commercial |
$366.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.24
|
| Rate for Payer: Healthscope Commercial |
$383.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$298.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.91
|
| Rate for Payer: PHP Commercial |
$362.57
|
| Rate for Payer: Priority Health SBD |
$268.73
|
| Rate for Payer: UMR Bronson Commercial |
$187.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.91
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
OP
|
$224.20
|
|
|
Service Code
|
NDC 00603548421
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.95 |
| Max. Negotiated Rate |
$201.78 |
| Rate for Payer: Aetna American Axle |
$145.73
|
| Rate for Payer: Aetna Commercial |
$190.57
|
| Rate for Payer: Aetna Medicare |
$112.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.73
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: Cash Price |
$179.36
|
| Rate for Payer: Cofinity Advantage |
$156.94
|
| Rate for Payer: Cofinity Commercial |
$192.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.36
|
| Rate for Payer: Healthscope Commercial |
$201.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.15
|
| Rate for Payer: PHP Commercial |
$190.57
|
| Rate for Payer: Priority Health SBD |
$141.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.73
|
| Rate for Payer: UHC Core |
$116.81
|
| Rate for Payer: UHC Exchange |
$88.11
|
| Rate for Payer: UMR Bronson Commercial |
$82.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.15
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
OP
|
$426.55
|
|
|
Service Code
|
NDC 00591555601
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.82 |
| Max. Negotiated Rate |
$383.89 |
| Rate for Payer: Aetna American Axle |
$277.26
|
| Rate for Payer: Aetna Commercial |
$362.57
|
| Rate for Payer: Aetna Medicare |
$213.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.26
|
| Rate for Payer: BCBS Complete |
$170.62
|
| Rate for Payer: Cash Price |
$341.24
|
| Rate for Payer: Cofinity Advantage |
$298.58
|
| Rate for Payer: Cofinity Commercial |
$366.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.24
|
| Rate for Payer: Healthscope Commercial |
$383.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$298.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.91
|
| Rate for Payer: PHP Commercial |
$362.57
|
| Rate for Payer: Priority Health SBD |
$268.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.26
|
| Rate for Payer: UHC Core |
$222.23
|
| Rate for Payer: UHC Exchange |
$167.63
|
| Rate for Payer: UMR Bronson Commercial |
$157.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.91
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
IP
|
$51.70
|
|
|
Service Code
|
NDC 23155011201
|
| Hospital Charge Code |
6658
|
|
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 40 MG TABLET
|
Facility
|
OP
|
$225.15
|
|
|
Service Code
|
NDC 00115166101
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.31 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna Medicare |
$112.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: BCBS Complete |
$90.06
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.35
|
| Rate for Payer: UHC Core |
$117.30
|
| Rate for Payer: UHC Exchange |
$88.48
|
| Rate for Payer: UMR Bronson Commercial |
$83.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
IP
|
$448.85
|
|
|
Service Code
|
NDC 69238207901
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$197.49 |
| Max. Negotiated Rate |
$403.96 |
| Rate for Payer: Aetna American Axle |
$291.75
|
| Rate for Payer: Aetna Commercial |
$381.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.75
|
| Rate for Payer: Cash Price |
$359.08
|
| Rate for Payer: Cofinity Advantage |
$314.19
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.08
|
| Rate for Payer: Healthscope Commercial |
$403.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.64
|
| Rate for Payer: PHP Commercial |
$381.52
|
| Rate for Payer: Priority Health SBD |
$282.78
|
| Rate for Payer: UMR Bronson Commercial |
$197.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.64
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
OP
|
$448.85
|
|
|
Service Code
|
NDC 69238207901
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$166.07 |
| Max. Negotiated Rate |
$403.96 |
| Rate for Payer: Aetna American Axle |
$291.75
|
| Rate for Payer: Aetna Commercial |
$381.52
|
| Rate for Payer: Aetna Medicare |
$224.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.75
|
| Rate for Payer: BCBS Complete |
$179.54
|
| Rate for Payer: Cash Price |
$359.08
|
| Rate for Payer: Cofinity Advantage |
$314.19
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.08
|
| Rate for Payer: Healthscope Commercial |
$403.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$359.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.64
|
| Rate for Payer: PHP Commercial |
$381.52
|
| Rate for Payer: Priority Health SBD |
$282.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.75
|
| Rate for Payer: UHC Core |
$233.85
|
| Rate for Payer: UHC Exchange |
$176.40
|
| Rate for Payer: UMR Bronson Commercial |
$166.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.64
|
|
|
PROPRANOLOL 40 MG TABLET
|
Facility
|
OP
|
$51.70
|
|
|
Service Code
|
NDC 23155011201
|
| Hospital Charge Code |
6658
|
|
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 40 MG TABLET
|
Facility
|
IP
|
$224.20
|
|
|
Service Code
|
NDC 00603548421
|
| Hospital Charge Code |
6658
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.65 |
| Max. Negotiated Rate |
$201.78 |
| Rate for Payer: Aetna American Axle |
$145.73
|
| Rate for Payer: Aetna Commercial |
$190.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.73
|
| Rate for Payer: Cash Price |
$179.36
|
| Rate for Payer: Cofinity Advantage |
$156.94
|
| Rate for Payer: Cofinity Commercial |
$192.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.36
|
| Rate for Payer: Healthscope Commercial |
$201.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.15
|
| Rate for Payer: PHP Commercial |
$190.57
|
| Rate for Payer: Priority Health SBD |
$141.25
|
| Rate for Payer: UMR Bronson Commercial |
$98.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.15
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$243.84
|
|
|
Service Code
|
NDC 51991081701
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.29 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Aetna American Axle |
$158.50
|
| Rate for Payer: Aetna Commercial |
$207.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.50
|
| Rate for Payer: Cash Price |
$195.07
|
| Rate for Payer: Cofinity Advantage |
$170.69
|
| Rate for Payer: Cofinity Commercial |
$209.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.07
|
| Rate for Payer: Healthscope Commercial |
$219.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.88
|
| Rate for Payer: PHP Commercial |
$207.26
|
| Rate for Payer: Priority Health SBD |
$153.62
|
| Rate for Payer: UMR Bronson Commercial |
$107.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.88
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$441.80
|
|
|
Service Code
|
NDC 00527411637
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.47 |
| Max. Negotiated Rate |
$397.62 |
| Rate for Payer: Aetna American Axle |
$287.17
|
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna Medicare |
$220.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: BCBS Complete |
$176.72
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cofinity Advantage |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.35
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: Priority Health SBD |
$278.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.17
|
| Rate for Payer: UHC Core |
$230.18
|
| Rate for Payer: UHC Exchange |
$173.63
|
| Rate for Payer: UMR Bronson Commercial |
$163.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.35
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$437.10
|
|
|
Service Code
|
NDC 62559053001
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.73 |
| Max. Negotiated Rate |
$393.39 |
| Rate for Payer: Aetna American Axle |
$284.12
|
| Rate for Payer: Aetna Commercial |
$371.54
|
| Rate for Payer: Aetna Medicare |
$218.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.12
|
| Rate for Payer: BCBS Complete |
$174.84
|
| Rate for Payer: Cash Price |
$349.68
|
| Rate for Payer: Cofinity Advantage |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$375.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.68
|
| Rate for Payer: Healthscope Commercial |
$393.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.82
|
| Rate for Payer: PHP Commercial |
$371.54
|
| Rate for Payer: Priority Health SBD |
$275.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.12
|
| Rate for Payer: UHC Core |
$227.73
|
| Rate for Payer: UHC Exchange |
$171.78
|
| Rate for Payer: UMR Bronson Commercial |
$161.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.82
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$243.84
|
|
|
Service Code
|
NDC 51991081701
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.22 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Aetna American Axle |
$158.50
|
| Rate for Payer: Aetna Commercial |
$207.26
|
| Rate for Payer: Aetna Medicare |
$121.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.50
|
| Rate for Payer: BCBS Complete |
$97.54
|
| Rate for Payer: Cash Price |
$195.07
|
| Rate for Payer: Cofinity Advantage |
$170.69
|
| Rate for Payer: Cofinity Commercial |
$209.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.07
|
| Rate for Payer: Healthscope Commercial |
$219.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.88
|
| Rate for Payer: PHP Commercial |
$207.26
|
| Rate for Payer: Priority Health SBD |
$153.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.50
|
| Rate for Payer: UHC Core |
$127.04
|
| Rate for Payer: UHC Exchange |
$95.83
|
| Rate for Payer: UMR Bronson Commercial |
$90.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.88
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$750.72
|
|
|
Service Code
|
NDC 00228277811
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$277.77 |
| Max. Negotiated Rate |
$675.65 |
| Rate for Payer: Aetna American Axle |
$487.97
|
| Rate for Payer: Aetna Commercial |
$638.11
|
| Rate for Payer: Aetna Medicare |
$375.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.97
|
| Rate for Payer: BCBS Complete |
$300.29
|
| Rate for Payer: Cash Price |
$600.58
|
| Rate for Payer: Cofinity Advantage |
$525.50
|
| Rate for Payer: Cofinity Commercial |
$645.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.58
|
| Rate for Payer: Healthscope Commercial |
$675.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$600.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.04
|
| Rate for Payer: PHP Commercial |
$638.11
|
| Rate for Payer: Priority Health SBD |
$472.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.97
|
| Rate for Payer: UHC Core |
$391.13
|
| Rate for Payer: UHC Exchange |
$295.03
|
| Rate for Payer: UMR Bronson Commercial |
$277.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.04
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$437.10
|
|
|
Service Code
|
NDC 62559053001
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$192.32 |
| Max. Negotiated Rate |
$393.39 |
| Rate for Payer: Aetna American Axle |
$284.12
|
| Rate for Payer: Aetna Commercial |
$371.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.12
|
| Rate for Payer: Cash Price |
$349.68
|
| Rate for Payer: Cofinity Advantage |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$375.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.68
|
| Rate for Payer: Healthscope Commercial |
$393.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.82
|
| Rate for Payer: PHP Commercial |
$371.54
|
| Rate for Payer: Priority Health SBD |
$275.37
|
| Rate for Payer: UMR Bronson Commercial |
$192.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.82
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$750.72
|
|
|
Service Code
|
NDC 00228277811
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$330.32 |
| Max. Negotiated Rate |
$675.65 |
| Rate for Payer: Aetna American Axle |
$487.97
|
| Rate for Payer: Aetna Commercial |
$638.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.97
|
| Rate for Payer: Cash Price |
$600.58
|
| Rate for Payer: Cofinity Advantage |
$525.50
|
| Rate for Payer: Cofinity Commercial |
$645.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.58
|
| Rate for Payer: Healthscope Commercial |
$675.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.04
|
| Rate for Payer: PHP Commercial |
$638.11
|
| Rate for Payer: Priority Health SBD |
$472.95
|
| Rate for Payer: UMR Bronson Commercial |
$330.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.04
|
|
|
PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$441.80
|
|
|
Service Code
|
NDC 00527411637
|
| Hospital Charge Code |
38224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$194.39 |
| Max. Negotiated Rate |
$397.62 |
| Rate for Payer: Aetna American Axle |
$287.17
|
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cofinity Advantage |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.35
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: Priority Health SBD |
$278.33
|
| Rate for Payer: UMR Bronson Commercial |
$194.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.35
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
OP
|
$198.55
|
|
|
Service Code
|
NDC 00527411737
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.46 |
| Max. Negotiated Rate |
$178.69 |
| Rate for Payer: Aetna American Axle |
$129.06
|
| Rate for Payer: Aetna Commercial |
$168.77
|
| Rate for Payer: Aetna Medicare |
$99.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.06
|
| Rate for Payer: BCBS Complete |
$79.42
|
| Rate for Payer: Cash Price |
$158.84
|
| Rate for Payer: Cofinity Advantage |
$138.99
|
| Rate for Payer: Cofinity Commercial |
$170.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.84
|
| Rate for Payer: Healthscope Commercial |
$178.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.91
|
| Rate for Payer: PHP Commercial |
$168.77
|
| Rate for Payer: Priority Health SBD |
$125.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.06
|
| Rate for Payer: UHC Core |
$103.44
|
| Rate for Payer: UHC Exchange |
$78.03
|
| Rate for Payer: UMR Bronson Commercial |
$73.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.91
|
|
|
PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE
|
Facility
|
IP
|
$285.12
|
|
|
Service Code
|
NDC 51991081801
|
| Hospital Charge Code |
38225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.45 |
| Max. Negotiated Rate |
$256.61 |
| Rate for Payer: Aetna American Axle |
$185.33
|
| Rate for Payer: Aetna Commercial |
$242.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.33
|
| Rate for Payer: Cash Price |
$228.10
|
| Rate for Payer: Cofinity Advantage |
$199.58
|
| Rate for Payer: Cofinity Commercial |
$245.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.10
|
| Rate for Payer: Healthscope Commercial |
$256.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.84
|
| Rate for Payer: PHP Commercial |
$242.35
|
| Rate for Payer: Priority Health SBD |
$179.63
|
| Rate for Payer: UMR Bronson Commercial |
$125.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.84
|
|
