|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.72
|
|
|
Service Code
|
NDC 55150022610
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$24.05 |
| Rate for Payer: Aetna American Axle |
$17.37
|
| Rate for Payer: Aetna Commercial |
$22.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.37
|
| Rate for Payer: Cash Price |
$21.38
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$22.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.38
|
| Rate for Payer: Healthscope Commercial |
$24.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.71
|
| Rate for Payer: PHP Commercial |
$22.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.37
|
| Rate for Payer: Priority Health SBD |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$11.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.04
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.01
|
|
|
Service Code
|
NDC 43547053110
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Aetna American Axle |
$12.36
|
| Rate for Payer: Aetna Commercial |
$16.16
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.36
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Cofinity Commercial |
$16.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.21
|
| Rate for Payer: Healthscope Commercial |
$17.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.16
|
| Rate for Payer: PHP Commercial |
$16.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health SBD |
$11.98
|
| Rate for Payer: UMR Bronson Commercial |
$7.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.26
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
NDC 71839014110
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.44
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$39.34
|
|
|
Service Code
|
NDC 63323042610
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$27.54
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: UMR Bronson Commercial |
$17.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$31.87
|
|
|
Service Code
|
NDC 00409955810
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.02 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna American Axle |
$20.72
|
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.72
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Commercial |
$22.31
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.72
|
| Rate for Payer: Priority Health SBD |
$20.08
|
| Rate for Payer: UMR Bronson Commercial |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.90
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.17
|
|
|
Service Code
|
NDC 72572065101
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$19.95 |
| Rate for Payer: Aetna American Axle |
$14.41
|
| Rate for Payer: Aetna Commercial |
$18.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.41
|
| Rate for Payer: Cash Price |
$17.74
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Cofinity Commercial |
$19.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.74
|
| Rate for Payer: Healthscope Commercial |
$19.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.84
|
| Rate for Payer: PHP Commercial |
$18.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.41
|
| Rate for Payer: Priority Health SBD |
$13.97
|
| Rate for Payer: UMR Bronson Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.63
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.16
|
|
|
Service Code
|
NDC 55150022505
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna American Axle |
$16.35
|
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.35
|
| Rate for Payer: Cash Price |
$20.13
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Cofinity Commercial |
$21.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.13
|
| Rate for Payer: Healthscope Commercial |
$22.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.35
|
| Rate for Payer: Priority Health SBD |
$15.85
|
| Rate for Payer: UMR Bronson Commercial |
$11.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.87
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.79
|
|
|
Service Code
|
NDC 39822420005
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$20.51 |
| Rate for Payer: Aetna American Axle |
$14.81
|
| Rate for Payer: Aetna Commercial |
$19.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.81
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$19.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$20.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: PHP Commercial |
$19.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.09
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.90
|
|
|
Service Code
|
NDC 71839014201
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: Aetna American Axle |
$18.14
|
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cofinity Commercial |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.72
|
| Rate for Payer: PHP Commercial |
$23.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.14
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: UMR Bronson Commercial |
$12.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.92
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.16
|
|
|
Service Code
|
NDC 55150022505
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna American Axle |
$16.35
|
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna Medicare |
$12.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.35
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: Cash Price |
$20.13
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Cofinity Commercial |
$21.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.13
|
| Rate for Payer: Healthscope Commercial |
$22.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.35
|
| Rate for Payer: Priority Health SBD |
$15.85
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.87
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.90
|
|
|
Service Code
|
NDC 25021066210
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$17.91 |
| Rate for Payer: Aetna American Axle |
$12.94
|
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna Medicare |
$9.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.94
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: Cash Price |
$15.92
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Commercial |
$17.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$17.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health SBD |
$12.54
|
| Rate for Payer: UMR Bronson Commercial |
$7.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.92
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.60
|
|
|
Service Code
|
NDC 70748034901
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$26.64 |
| Rate for Payer: Aetna American Axle |
$19.24
|
| Rate for Payer: Aetna Commercial |
$25.16
|
| Rate for Payer: Aetna Medicare |
$14.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.24
|
| Rate for Payer: BCBS Complete |
$11.84
|
| Rate for Payer: Cash Price |
$23.68
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$25.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.68
|
| Rate for Payer: Healthscope Commercial |
$26.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.16
|
| Rate for Payer: PHP Commercial |
$25.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.24
|
| Rate for Payer: Priority Health SBD |
$18.65
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.20
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.13
|
|
|
Service Code
|
NDC 00409703710
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$23.52 |
| Rate for Payer: Aetna American Axle |
$16.98
|
| Rate for Payer: Aetna Commercial |
$22.21
|
| Rate for Payer: Aetna Medicare |
$13.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.98
|
| Rate for Payer: BCBS Complete |
$10.45
|
| Rate for Payer: Cash Price |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$18.29
|
| Rate for Payer: Cofinity Commercial |
$22.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.90
|
| Rate for Payer: Healthscope Commercial |
$23.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.21
|
| Rate for Payer: PHP Commercial |
$22.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.98
|
| Rate for Payer: Priority Health SBD |
$16.46
|
| Rate for Payer: UMR Bronson Commercial |
$9.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.60
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$45.53
|
|
|
Service Code
|
NDC 70860065142
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.03 |
| Max. Negotiated Rate |
$40.98 |
| Rate for Payer: Aetna American Axle |
$29.59
|
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.59
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$31.87
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$40.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: PHP Commercial |
$38.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.59
|
| Rate for Payer: Priority Health SBD |
$28.68
|
| Rate for Payer: UMR Bronson Commercial |
$20.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.15
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$39.34
|
|
|
Service Code
|
NDC 63323042601
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Medicare |
$19.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$27.54
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: UMR Bronson Commercial |
$14.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$39.34
|
|
|
Service Code
|
NDC 63323042601
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.31 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$27.54
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: UMR Bronson Commercial |
$17.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.01
|
|
|
Service Code
|
NDC 43547053101
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Aetna American Axle |
$12.36
|
| Rate for Payer: Aetna Commercial |
$16.16
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.36
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Cofinity Commercial |
$16.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.21
|
| Rate for Payer: Healthscope Commercial |
$17.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.16
|
| Rate for Payer: PHP Commercial |
$16.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health SBD |
$11.98
|
| Rate for Payer: UMR Bronson Commercial |
$7.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.26
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.45
|
|
|
Service Code
|
NDC 66794022902
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna American Axle |
$12.64
|
| Rate for Payer: Aetna Commercial |
$16.53
|
| Rate for Payer: Aetna Medicare |
$9.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.64
|
| Rate for Payer: BCBS Complete |
$7.78
|
| Rate for Payer: Cash Price |
$15.56
|
| Rate for Payer: Cofinity Commercial |
$13.62
|
| Rate for Payer: Cofinity Commercial |
$16.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$17.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.53
|
| Rate for Payer: PHP Commercial |
$16.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.64
|
| Rate for Payer: Priority Health SBD |
$12.25
|
| Rate for Payer: UMR Bronson Commercial |
$7.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.59
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.42
|
|
|
Service Code
|
NDC 25021068710
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Aetna American Axle |
$15.87
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.87
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.32
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.49
|
|
|
Service Code
|
NDC 00409318905
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna American Axle |
$15.27
|
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$11.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.27
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$16.44
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.27
|
| Rate for Payer: Priority Health SBD |
$14.80
|
| Rate for Payer: UMR Bronson Commercial |
$8.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.53
|
|
|
Service Code
|
NDC 70860065110
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$40.98 |
| Rate for Payer: Aetna American Axle |
$29.59
|
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.59
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$31.87
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$40.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: PHP Commercial |
$38.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.59
|
| Rate for Payer: Priority Health SBD |
$28.68
|
| Rate for Payer: UMR Bronson Commercial |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.15
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.87
|
|
|
Service Code
|
NDC 00143925101
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$20.58 |
| Rate for Payer: Aetna American Axle |
$14.87
|
| Rate for Payer: Aetna Commercial |
$19.44
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.87
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$19.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.30
|
| Rate for Payer: Healthscope Commercial |
$20.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.44
|
| Rate for Payer: PHP Commercial |
$19.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.87
|
| Rate for Payer: Priority Health SBD |
$14.41
|
| Rate for Payer: UMR Bronson Commercial |
$8.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.15
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.87
|
|
|
Service Code
|
NDC 00143925101
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$20.58 |
| Rate for Payer: Aetna American Axle |
$14.87
|
| Rate for Payer: Aetna Commercial |
$19.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.87
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$19.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.30
|
| Rate for Payer: Healthscope Commercial |
$20.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.44
|
| Rate for Payer: PHP Commercial |
$19.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.87
|
| Rate for Payer: Priority Health SBD |
$14.41
|
| Rate for Payer: UMR Bronson Commercial |
$10.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.15
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
NDC 71839014101
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.44
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$27.90
|
|
|
Service Code
|
NDC 71839014201
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: Aetna American Axle |
$18.14
|
| Rate for Payer: Aetna Commercial |
$23.72
|
| Rate for Payer: Aetna Medicare |
$13.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: BCBS Complete |
$11.16
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cofinity Commercial |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.72
|
| Rate for Payer: PHP Commercial |
$23.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.14
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.92
|
|
