|
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
IP
|
$33.65
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
153276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.81 |
| Max. Negotiated Rate |
$30.28 |
| Rate for Payer: Aetna American Axle |
$21.87
|
| Rate for Payer: Aetna American Axle |
$19.05
|
| Rate for Payer: Aetna American Axle |
$18.49
|
| Rate for Payer: Aetna American Axle |
$15.89
|
| Rate for Payer: Aetna American Axle |
$11.72
|
| Rate for Payer: Aetna American Axle |
$13.36
|
| Rate for Payer: Aetna American Axle |
$16.17
|
| Rate for Payer: Aetna American Axle |
$52.59
|
| Rate for Payer: Aetna Commercial |
$68.77
|
| Rate for Payer: Aetna Commercial |
$28.60
|
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$17.48
|
| Rate for Payer: Aetna Commercial |
$15.33
|
| Rate for Payer: Aetna Commercial |
$24.91
|
| Rate for Payer: Aetna Commercial |
$24.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.49
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$64.73
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$19.55
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cash Price |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$17.11
|
| Rate for Payer: Cofinity Commercial |
$14.39
|
| Rate for Payer: Cofinity Commercial |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$21.02
|
| Rate for Payer: Cofinity Commercial |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$56.64
|
| Rate for Payer: Cofinity Commercial |
$69.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.55
|
| Rate for Payer: Healthscope Commercial |
$16.23
|
| Rate for Payer: Healthscope Commercial |
$72.82
|
| Rate for Payer: Healthscope Commercial |
$30.28
|
| Rate for Payer: Healthscope Commercial |
$25.60
|
| Rate for Payer: Healthscope Commercial |
$26.38
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$22.00
|
| Rate for Payer: Healthscope Commercial |
$18.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.77
|
| Rate for Payer: PHP Commercial |
$28.60
|
| Rate for Payer: PHP Commercial |
$20.77
|
| Rate for Payer: PHP Commercial |
$24.91
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$68.77
|
| Rate for Payer: PHP Commercial |
$15.33
|
| Rate for Payer: PHP Commercial |
$24.17
|
| Rate for Payer: PHP Commercial |
$17.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.89
|
| Rate for Payer: Priority Health SBD |
$15.40
|
| Rate for Payer: Priority Health SBD |
$12.95
|
| Rate for Payer: Priority Health SBD |
$11.36
|
| Rate for Payer: Priority Health SBD |
$15.67
|
| Rate for Payer: Priority Health SBD |
$18.47
|
| Rate for Payer: Priority Health SBD |
$17.92
|
| Rate for Payer: Priority Health SBD |
$50.97
|
| Rate for Payer: Priority Health SBD |
$21.20
|
| Rate for Payer: UMR Bronson Commercial |
$10.75
|
| Rate for Payer: UMR Bronson Commercial |
$10.94
|
| Rate for Payer: UMR Bronson Commercial |
$12.90
|
| Rate for Payer: UMR Bronson Commercial |
$14.81
|
| Rate for Payer: UMR Bronson Commercial |
$9.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.60
|
| Rate for Payer: UMR Bronson Commercial |
$12.51
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.33
|
|
|
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
OP
|
$80.91
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
153276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$72.82 |
| Rate for Payer: Aetna American Axle |
$52.59
|
| Rate for Payer: Aetna American Axle |
$21.87
|
| Rate for Payer: Aetna American Axle |
$18.49
|
| Rate for Payer: Aetna American Axle |
$16.17
|
| Rate for Payer: Aetna American Axle |
$19.05
|
| Rate for Payer: Aetna American Axle |
$11.72
|
| Rate for Payer: Aetna American Axle |
$15.89
|
| Rate for Payer: Aetna American Axle |
$13.36
|
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Commercial |
$15.33
|
| Rate for Payer: Aetna Commercial |
$17.48
|
| Rate for Payer: Aetna Commercial |
$24.17
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$24.91
|
| Rate for Payer: Aetna Commercial |
$28.60
|
| Rate for Payer: Aetna Commercial |
$68.77
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Aetna Medicare |
$10.28
|
| Rate for Payer: Aetna Medicare |
$16.82
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Aetna Medicare |
$40.46
|
| Rate for Payer: Aetna Medicare |
$14.22
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Aetna Medicare |
$14.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.49
|
| Rate for Payer: BCBS Complete |
$32.36
|
| Rate for Payer: BCBS Complete |
$11.72
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: BCBS Complete |
$7.21
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS Complete |
$13.46
|
| Rate for Payer: BCBS Complete |
$11.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$19.55
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cash Price |
$19.55
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$23.45
|
| Rate for Payer: Cash Price |
$23.45
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$64.73
|
| Rate for Payer: Cash Price |
$64.73
|
| Rate for Payer: Cofinity Commercial |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Cofinity Commercial |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$56.64
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$17.11
|
| Rate for Payer: Cofinity Commercial |
$14.39
|
| Rate for Payer: Cofinity Commercial |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$21.02
|
| Rate for Payer: Cofinity Commercial |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$69.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Healthscope Commercial |
$22.00
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$30.28
|
| Rate for Payer: Healthscope Commercial |
$72.82
|
| Rate for Payer: Healthscope Commercial |
$26.38
|
| Rate for Payer: Healthscope Commercial |
$16.23
|
| Rate for Payer: Healthscope Commercial |
$18.50
|
| Rate for Payer: Healthscope Commercial |
$25.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$24.91
|
| Rate for Payer: PHP Commercial |
$17.48
|
| Rate for Payer: PHP Commercial |
$68.77
|
| Rate for Payer: PHP Commercial |
$24.17
|
| Rate for Payer: PHP Commercial |
$15.33
|
| Rate for Payer: PHP Commercial |
$20.77
|
| Rate for Payer: PHP Commercial |
$28.60
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.87
|
| Rate for Payer: Priority Health SBD |
$11.36
|
| Rate for Payer: Priority Health SBD |
$50.97
|
| Rate for Payer: Priority Health SBD |
$15.67
|
| Rate for Payer: Priority Health SBD |
$17.92
|
| Rate for Payer: Priority Health SBD |
$12.95
|
| Rate for Payer: Priority Health SBD |
$15.40
|
| Rate for Payer: Priority Health SBD |
$21.20
|
| Rate for Payer: Priority Health SBD |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$12.45
|
| Rate for Payer: UMR Bronson Commercial |
$29.94
|
| Rate for Payer: UMR Bronson Commercial |
$10.84
|
| Rate for Payer: UMR Bronson Commercial |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$7.61
|
| Rate for Payer: UMR Bronson Commercial |
$6.67
|
| Rate for Payer: UMR Bronson Commercial |
$9.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.52
|
|
|
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION
|
Facility
|
IP
|
$20.65
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$18.58 |
| Rate for Payer: Aetna American Axle |
$13.42
|
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.42
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: UMR Bronson Commercial |
$9.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.49
|
|
|
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION
|
Facility
|
OP
|
$20.65
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$18.58 |
| Rate for Payer: Aetna American Axle |
$13.42
|
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.42
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: UMR Bronson Commercial |
$7.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.49
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$493.44
|
|
|
Service Code
|
NDC 00904677961
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.57 |
| Max. Negotiated Rate |
$444.10 |
| Rate for Payer: Aetna American Axle |
$320.74
|
| Rate for Payer: Aetna Commercial |
$419.42
|
| Rate for Payer: Aetna Medicare |
$246.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: BCBS Complete |
$197.38
|
| Rate for Payer: Cash Price |
$394.75
|
| Rate for Payer: Cofinity Commercial |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$424.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.75
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.42
|
| Rate for Payer: PHP Commercial |
$419.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.74
|
| Rate for Payer: Priority Health SBD |
$310.87
|
| Rate for Payer: UMR Bronson Commercial |
$182.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.08
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$227.53
|
|
|
Service Code
|
NDC 60687024565
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.19 |
| Max. Negotiated Rate |
$204.78 |
| Rate for Payer: Aetna American Axle |
$147.89
|
| Rate for Payer: Aetna Commercial |
$193.40
|
| Rate for Payer: Aetna Medicare |
$113.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.89
|
| Rate for Payer: BCBS Complete |
$91.01
|
| Rate for Payer: Cash Price |
$182.02
|
| Rate for Payer: Cofinity Commercial |
$159.27
|
| Rate for Payer: Cofinity Commercial |
$195.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.02
|
| Rate for Payer: Healthscope Commercial |
$204.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.40
|
| Rate for Payer: PHP Commercial |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.89
|
| Rate for Payer: Priority Health SBD |
$143.34
|
| Rate for Payer: UMR Bronson Commercial |
$84.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.65
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$219.96
|
|
|
Service Code
|
NDC 13668018090
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.39 |
| Max. Negotiated Rate |
$197.96 |
| Rate for Payer: Aetna American Axle |
$142.97
|
| Rate for Payer: Aetna Commercial |
$186.97
|
| Rate for Payer: Aetna Medicare |
$109.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.97
|
| Rate for Payer: BCBS Complete |
$87.98
|
| Rate for Payer: Cash Price |
$175.97
|
| Rate for Payer: Cofinity Commercial |
$153.97
|
| Rate for Payer: Cofinity Commercial |
$189.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.97
|
| Rate for Payer: Healthscope Commercial |
$197.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.97
|
| Rate for Payer: PHP Commercial |
$186.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.97
|
| Rate for Payer: Priority Health SBD |
$138.57
|
| Rate for Payer: UMR Bronson Commercial |
$81.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.97
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$219.96
|
|
|
Service Code
|
NDC 13668018090
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.78 |
| Max. Negotiated Rate |
$197.96 |
| Rate for Payer: Aetna American Axle |
$142.97
|
| Rate for Payer: Aetna Commercial |
$186.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.97
|
| Rate for Payer: Cash Price |
$175.97
|
| Rate for Payer: Cofinity Commercial |
$153.97
|
| Rate for Payer: Cofinity Commercial |
$189.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.97
|
| Rate for Payer: Healthscope Commercial |
$197.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.97
|
| Rate for Payer: PHP Commercial |
$186.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.97
|
| Rate for Payer: Priority Health SBD |
$138.57
|
| Rate for Payer: UMR Bronson Commercial |
$96.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.97
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$175.55
|
|
|
Service Code
|
NDC 31722088390
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.24 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$77.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$175.55
|
|
|
Service Code
|
NDC 31722088390
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna Medicare |
$87.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$64.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$493.44
|
|
|
Service Code
|
NDC 00904677961
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$217.11 |
| Max. Negotiated Rate |
$444.10 |
| Rate for Payer: Aetna American Axle |
$320.74
|
| Rate for Payer: Aetna Commercial |
$419.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Cash Price |
$394.75
|
| Rate for Payer: Cofinity Commercial |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$424.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.75
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.42
|
| Rate for Payer: PHP Commercial |
$419.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.74
|
| Rate for Payer: Priority Health SBD |
$310.87
|
| Rate for Payer: UMR Bronson Commercial |
$217.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.08
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$5.42
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Aetna American Axle |
$3.52
|
| Rate for Payer: Aetna Commercial |
$4.61
|
| Rate for Payer: Aetna Medicare |
$2.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.52
|
| Rate for Payer: BCBS Complete |
$2.17
|
| Rate for Payer: Cash Price |
$4.34
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.34
|
| Rate for Payer: Healthscope Commercial |
$4.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.61
|
| Rate for Payer: PHP Commercial |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.52
|
| Rate for Payer: Priority Health SBD |
$3.41
|
| Rate for Payer: UMR Bronson Commercial |
$2.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.06
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$227.53
|
|
|
Service Code
|
NDC 60687024565
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$204.78 |
| Rate for Payer: Aetna American Axle |
$147.89
|
| Rate for Payer: Aetna Commercial |
$193.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.89
|
| Rate for Payer: Cash Price |
$182.02
|
| Rate for Payer: Cofinity Commercial |
$159.27
|
| Rate for Payer: Cofinity Commercial |
$195.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$159.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.02
|
| Rate for Payer: Healthscope Commercial |
$204.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.40
|
| Rate for Payer: PHP Commercial |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.89
|
| Rate for Payer: Priority Health SBD |
$143.34
|
| Rate for Payer: UMR Bronson Commercial |
$100.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.65
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$5.42
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Aetna American Axle |
$3.52
|
| Rate for Payer: Aetna Commercial |
$4.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.52
|
| Rate for Payer: Cash Price |
$4.34
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.34
|
| Rate for Payer: Healthscope Commercial |
$4.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.61
|
| Rate for Payer: PHP Commercial |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.52
|
| Rate for Payer: Priority Health SBD |
$3.41
|
| Rate for Payer: UMR Bronson Commercial |
$2.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.06
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$175.55
|
|
|
Service Code
|
NDC 31722088490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna Medicare |
$87.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$64.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$241.11
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.21 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Aetna American Axle |
$156.72
|
| Rate for Payer: Aetna Commercial |
$204.94
|
| Rate for Payer: Aetna Medicare |
$120.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.72
|
| Rate for Payer: BCBS Complete |
$96.44
|
| Rate for Payer: Cash Price |
$192.89
|
| Rate for Payer: Cofinity Commercial |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$207.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$168.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.89
|
| Rate for Payer: Healthscope Commercial |
$217.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.94
|
| Rate for Payer: PHP Commercial |
$204.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.72
|
| Rate for Payer: Priority Health SBD |
$151.90
|
| Rate for Payer: UMR Bronson Commercial |
$89.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.83
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$3.08
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Aetna American Axle |
$2.00
|
| Rate for Payer: Aetna Commercial |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.00
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.46
|
| Rate for Payer: Healthscope Commercial |
$2.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.62
|
| Rate for Payer: PHP Commercial |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.00
|
| Rate for Payer: Priority Health SBD |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$1.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.31
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$153.84
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna American Axle |
$100.00
|
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna Medicare |
$76.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.00
|
| Rate for Payer: BCBS Complete |
$61.54
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cofinity Commercial |
$107.69
|
| Rate for Payer: Cofinity Commercial |
$132.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.07
|
| Rate for Payer: Healthscope Commercial |
$138.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.76
|
| Rate for Payer: PHP Commercial |
$130.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.00
|
| Rate for Payer: Priority Health SBD |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$56.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.38
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$224.19
|
|
|
Service Code
|
NDC 27808015701
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.64 |
| Max. Negotiated Rate |
$201.77 |
| Rate for Payer: Aetna American Axle |
$145.72
|
| Rate for Payer: Aetna Commercial |
$190.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.72
|
| Rate for Payer: Cash Price |
$179.35
|
| Rate for Payer: Cofinity Commercial |
$156.93
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.35
|
| Rate for Payer: Healthscope Commercial |
$201.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.56
|
| Rate for Payer: PHP Commercial |
$190.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.72
|
| Rate for Payer: Priority Health SBD |
$141.24
|
| Rate for Payer: UMR Bronson Commercial |
$98.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.14
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$153.84
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna American Axle |
$100.00
|
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.00
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cofinity Commercial |
$107.69
|
| Rate for Payer: Cofinity Commercial |
$132.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.07
|
| Rate for Payer: Healthscope Commercial |
$138.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.76
|
| Rate for Payer: PHP Commercial |
$130.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.00
|
| Rate for Payer: Priority Health SBD |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$67.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.38
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$241.11
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.09 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Aetna American Axle |
$156.72
|
| Rate for Payer: Aetna Commercial |
$204.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.72
|
| Rate for Payer: Cash Price |
$192.89
|
| Rate for Payer: Cofinity Commercial |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$207.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$168.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.89
|
| Rate for Payer: Healthscope Commercial |
$217.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.94
|
| Rate for Payer: PHP Commercial |
$204.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.72
|
| Rate for Payer: Priority Health SBD |
$151.90
|
| Rate for Payer: UMR Bronson Commercial |
$106.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.83
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$175.55
|
|
|
Service Code
|
NDC 31722088490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.24 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$77.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$2,862.47
|
|
|
Service Code
|
NDC 00310075290
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,259.49 |
| Max. Negotiated Rate |
$2,576.22 |
| Rate for Payer: Aetna American Axle |
$1,860.61
|
| Rate for Payer: Aetna Commercial |
$2,433.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,860.61
|
| Rate for Payer: Cash Price |
$2,289.98
|
| Rate for Payer: Cofinity Commercial |
$2,003.73
|
| Rate for Payer: Cofinity Commercial |
$2,461.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,003.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.98
|
| Rate for Payer: Healthscope Commercial |
$2,576.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,003.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,433.10
|
| Rate for Payer: PHP Commercial |
$2,433.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,860.61
|
| Rate for Payer: Priority Health SBD |
$1,803.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.85
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$222.30
|
|
|
Service Code
|
NDC 00781540292
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.81 |
| Max. Negotiated Rate |
$200.07 |
| Rate for Payer: Aetna American Axle |
$144.50
|
| Rate for Payer: Aetna Commercial |
$188.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.50
|
| Rate for Payer: Cash Price |
$177.84
|
| Rate for Payer: Cofinity Commercial |
$155.61
|
| Rate for Payer: Cofinity Commercial |
$191.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$155.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.84
|
| Rate for Payer: Healthscope Commercial |
$200.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$155.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.96
|
| Rate for Payer: PHP Commercial |
$188.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.50
|
| Rate for Payer: Priority Health SBD |
$140.05
|
| Rate for Payer: UMR Bronson Commercial |
$97.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.72
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$3.08
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Aetna American Axle |
$2.00
|
| Rate for Payer: Aetna Commercial |
$2.62
|
| Rate for Payer: Aetna Medicare |
$1.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.23
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.46
|
| Rate for Payer: Healthscope Commercial |
$2.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.62
|
| Rate for Payer: PHP Commercial |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.00
|
| Rate for Payer: Priority Health SBD |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.31
|
|
