|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
IP
|
$18,251.51
|
|
|
Service Code
|
NDC 00004003822
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8,030.66 |
| Max. Negotiated Rate |
$16,426.36 |
| Rate for Payer: Aetna American Axle |
$11,863.48
|
| Rate for Payer: Aetna Commercial |
$15,513.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,863.48
|
| Rate for Payer: Cash Price |
$14,601.21
|
| Rate for Payer: Cofinity Advantage |
$12,776.06
|
| Rate for Payer: Cofinity Commercial |
$15,696.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,601.21
|
| Rate for Payer: Healthscope Commercial |
$16,426.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,776.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,688.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,513.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,688.63
|
| Rate for Payer: PHP Commercial |
$15,513.78
|
| Rate for Payer: Priority Health SBD |
$11,498.45
|
| Rate for Payer: UMR Bronson Commercial |
$8,030.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,688.63
|
|
|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
OP
|
$719.80
|
|
|
Service Code
|
NDC 50268078712
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$266.33 |
| Max. Negotiated Rate |
$647.82 |
| Rate for Payer: Aetna American Axle |
$467.87
|
| Rate for Payer: Aetna Commercial |
$611.83
|
| Rate for Payer: Aetna Medicare |
$359.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.87
|
| Rate for Payer: BCBS Complete |
$287.92
|
| Rate for Payer: Cash Price |
$575.84
|
| Rate for Payer: Cofinity Advantage |
$503.86
|
| Rate for Payer: Cofinity Commercial |
$619.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.84
|
| Rate for Payer: Healthscope Commercial |
$647.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.85
|
| Rate for Payer: PHP Commercial |
$611.83
|
| Rate for Payer: Priority Health SBD |
$453.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.87
|
| Rate for Payer: UHC Core |
$375.02
|
| Rate for Payer: UHC Exchange |
$282.88
|
| Rate for Payer: UMR Bronson Commercial |
$266.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.85
|
|
|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
OP
|
$18,251.51
|
|
|
Service Code
|
NDC 00004003822
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6,753.06 |
| Max. Negotiated Rate |
$16,426.36 |
| Rate for Payer: Aetna American Axle |
$11,863.48
|
| Rate for Payer: Aetna Commercial |
$15,513.78
|
| Rate for Payer: Aetna Medicare |
$9,125.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,863.48
|
| Rate for Payer: BCBS Complete |
$7,300.60
|
| Rate for Payer: Cash Price |
$14,601.21
|
| Rate for Payer: Cofinity Advantage |
$12,776.06
|
| Rate for Payer: Cofinity Commercial |
$15,696.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,601.21
|
| Rate for Payer: Healthscope Commercial |
$16,426.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,776.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,688.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,601.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,513.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,688.63
|
| Rate for Payer: PHP Commercial |
$15,513.78
|
| Rate for Payer: Priority Health SBD |
$11,498.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,863.48
|
| Rate for Payer: UHC Core |
$9,509.04
|
| Rate for Payer: UHC Exchange |
$7,172.84
|
| Rate for Payer: UMR Bronson Commercial |
$6,753.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,688.63
|
|
|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
IP
|
$719.80
|
|
|
Service Code
|
NDC 50268078712
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$316.71 |
| Max. Negotiated Rate |
$647.82 |
| Rate for Payer: Aetna American Axle |
$467.87
|
| Rate for Payer: Aetna Commercial |
$611.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.87
|
| Rate for Payer: Cash Price |
$575.84
|
| Rate for Payer: Cofinity Advantage |
$503.86
|
| Rate for Payer: Cofinity Commercial |
$619.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.84
|
| Rate for Payer: Healthscope Commercial |
$647.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.85
|
| Rate for Payer: PHP Commercial |
$611.83
|
| Rate for Payer: Priority Health SBD |
$453.47
|
| Rate for Payer: UMR Bronson Commercial |
$316.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.85
|
|
|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
IP
|
$600.74
|
|
|
Service Code
|
NDC 31722083260
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$264.33 |
| Max. Negotiated Rate |
$540.67 |
| Rate for Payer: Aetna American Axle |
$390.48
|
| Rate for Payer: Aetna Commercial |
$510.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.48
|
| Rate for Payer: Cash Price |
$480.59
|
| Rate for Payer: Cofinity Advantage |
$420.52
|
| Rate for Payer: Cofinity Commercial |
$516.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.59
|
| Rate for Payer: Healthscope Commercial |
$540.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.56
|
| Rate for Payer: PHP Commercial |
$510.63
|
| Rate for Payer: Priority Health SBD |
$378.47
|
| Rate for Payer: UMR Bronson Commercial |
$264.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.56
|
|
|
VALGANCICLOVIR 450 MG TABLET
|
Facility
|
IP
|
$35.99
|
|
|
Service Code
|
NDC 50268078711
|
| Hospital Charge Code |
30148
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.84 |
| Max. Negotiated Rate |
$32.39 |
| Rate for Payer: Aetna American Axle |
$23.39
|
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.39
|
| Rate for Payer: Cash Price |
$28.79
|
| Rate for Payer: Cofinity Advantage |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$30.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.79
|
| Rate for Payer: Healthscope Commercial |
$32.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.99
|
| Rate for Payer: PHP Commercial |
$30.59
|
| Rate for Payer: Priority Health SBD |
$22.67
|
| Rate for Payer: UMR Bronson Commercial |
$15.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.99
|
|
|
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$1,793.41
|
|
|
Service Code
|
NDC 72205001901
|
| Hospital Charge Code |
99443
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$789.10 |
| Max. Negotiated Rate |
$1,614.07 |
| Rate for Payer: Aetna American Axle |
$1,165.72
|
| Rate for Payer: Aetna Commercial |
$1,524.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.72
|
| Rate for Payer: Cash Price |
$1,434.73
|
| Rate for Payer: Cofinity Advantage |
$1,255.39
|
| Rate for Payer: Cofinity Commercial |
$1,542.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,434.73
|
| Rate for Payer: Healthscope Commercial |
$1,614.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,255.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,345.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,524.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,345.06
|
| Rate for Payer: PHP Commercial |
$1,524.40
|
| Rate for Payer: Priority Health SBD |
$1,129.85
|
| Rate for Payer: UMR Bronson Commercial |
$789.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,345.06
|
|
|
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$3,682.54
|
|
|
Service Code
|
NDC 00004003909
|
| Hospital Charge Code |
99443
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,362.54 |
| Max. Negotiated Rate |
$3,314.29 |
| Rate for Payer: Aetna American Axle |
$2,393.65
|
| Rate for Payer: Aetna Commercial |
$3,130.16
|
| Rate for Payer: Aetna Medicare |
$1,841.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,393.65
|
| Rate for Payer: BCBS Complete |
$1,473.02
|
| Rate for Payer: Cash Price |
$2,946.03
|
| Rate for Payer: Cofinity Advantage |
$2,577.78
|
| Rate for Payer: Cofinity Commercial |
$3,166.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.03
|
| Rate for Payer: Healthscope Commercial |
$3,314.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,577.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,761.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,946.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,761.91
|
| Rate for Payer: PHP Commercial |
$3,130.16
|
| Rate for Payer: Priority Health SBD |
$2,320.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,393.65
|
| Rate for Payer: UHC Core |
$1,918.60
|
| Rate for Payer: UHC Exchange |
$1,447.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,362.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,761.91
|
|
|
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$3,682.54
|
|
|
Service Code
|
NDC 00004003909
|
| Hospital Charge Code |
99443
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,620.32 |
| Max. Negotiated Rate |
$3,314.29 |
| Rate for Payer: Aetna American Axle |
$2,393.65
|
| Rate for Payer: Aetna Commercial |
$3,130.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,393.65
|
| Rate for Payer: Cash Price |
$2,946.03
|
| Rate for Payer: Cofinity Advantage |
$2,577.78
|
| Rate for Payer: Cofinity Commercial |
$3,166.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.03
|
| Rate for Payer: Healthscope Commercial |
$3,314.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,577.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,761.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,761.91
|
| Rate for Payer: PHP Commercial |
$3,130.16
|
| Rate for Payer: Priority Health SBD |
$2,320.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,620.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,761.91
|
|
|
VALGANCICLOVIR 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$1,793.41
|
|
|
Service Code
|
NDC 72205001901
|
| Hospital Charge Code |
99443
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$663.56 |
| Max. Negotiated Rate |
$1,614.07 |
| Rate for Payer: Aetna American Axle |
$1,165.72
|
| Rate for Payer: Aetna Commercial |
$1,524.40
|
| Rate for Payer: Aetna Medicare |
$896.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.72
|
| Rate for Payer: BCBS Complete |
$717.36
|
| Rate for Payer: Cash Price |
$1,434.73
|
| Rate for Payer: Cofinity Advantage |
$1,255.39
|
| Rate for Payer: Cofinity Commercial |
$1,542.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,434.73
|
| Rate for Payer: Healthscope Commercial |
$1,614.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,255.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,345.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,434.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,524.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,345.06
|
| Rate for Payer: PHP Commercial |
$1,524.40
|
| Rate for Payer: Priority Health SBD |
$1,129.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,165.72
|
| Rate for Payer: UHC Core |
$934.37
|
| Rate for Payer: UHC Exchange |
$704.81
|
| Rate for Payer: UMR Bronson Commercial |
$663.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,345.06
|
|
|
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.79
|
|
|
Service Code
|
HCPCS J3379
|
| Hospital Charge Code |
20887
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$25.91 |
| Rate for Payer: Aetna American Axle |
$18.71
|
| Rate for Payer: Aetna American Axle |
$10.51
|
| Rate for Payer: Aetna American Axle |
$19.38
|
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Commercial |
$13.74
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Aetna Medicare |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: BCBS Complete |
$6.47
|
| Rate for Payer: BCBS Complete |
$11.52
|
| Rate for Payer: BCBS Complete |
$11.93
|
| 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: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Advantage |
$20.15
|
| Rate for Payer: Cofinity Advantage |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.03
|
| Rate for Payer: Healthscope Commercial |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$25.91
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$24.47
|
| Rate for Payer: PHP Commercial |
$13.74
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$10.19
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: Priority Health SBD |
$18.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UMR Bronson Commercial |
$11.03
|
| Rate for Payer: UMR Bronson Commercial |
$5.98
|
| Rate for Payer: UMR Bronson Commercial |
$10.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.17
|
|
|
Service Code
|
HCPCS J3379
|
| Hospital Charge Code |
20887
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.11 |
| Max. Negotiated Rate |
$14.55 |
| Rate for Payer: Aetna American Axle |
$10.51
|
| Rate for Payer: Aetna American Axle |
$19.38
|
| Rate for Payer: Aetna American Axle |
$18.71
|
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: Aetna Commercial |
$13.74
|
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.71
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Advantage |
$11.32
|
| Rate for Payer: Cofinity Advantage |
$20.15
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$25.91
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Healthscope Commercial |
$14.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$24.47
|
| Rate for Payer: PHP Commercial |
$13.74
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$10.19
|
| Rate for Payer: Priority Health SBD |
$18.14
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: UMR Bronson Commercial |
$7.11
|
| Rate for Payer: UMR Bronson Commercial |
$13.12
|
| Rate for Payer: UMR Bronson Commercial |
$12.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
IP
|
$386.65
|
|
|
Service Code
|
NDC 00832031011
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.13 |
| Max. Negotiated Rate |
$347.99 |
| Rate for Payer: Aetna American Axle |
$251.32
|
| Rate for Payer: Aetna Commercial |
$328.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.32
|
| Rate for Payer: Cash Price |
$309.32
|
| Rate for Payer: Cofinity Advantage |
$270.65
|
| Rate for Payer: Cofinity Commercial |
$332.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.32
|
| Rate for Payer: Healthscope Commercial |
$347.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.99
|
| Rate for Payer: PHP Commercial |
$328.65
|
| Rate for Payer: Priority Health SBD |
$243.59
|
| Rate for Payer: UMR Bronson Commercial |
$170.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.99
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
IP
|
$293.55
|
|
|
Service Code
|
NDC 63739008610
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.16 |
| Max. Negotiated Rate |
$264.19 |
| Rate for Payer: Aetna American Axle |
$190.81
|
| Rate for Payer: Aetna Commercial |
$249.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.81
|
| Rate for Payer: Cash Price |
$234.84
|
| Rate for Payer: Cofinity Advantage |
$205.49
|
| Rate for Payer: Cofinity Commercial |
$252.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.84
|
| Rate for Payer: Healthscope Commercial |
$264.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.16
|
| Rate for Payer: PHP Commercial |
$249.52
|
| Rate for Payer: Priority Health SBD |
$184.94
|
| Rate for Payer: UMR Bronson Commercial |
$129.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.16
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
OP
|
$353.40
|
|
|
Service Code
|
NDC 00591401201
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.76 |
| Max. Negotiated Rate |
$318.06 |
| Rate for Payer: Aetna American Axle |
$229.71
|
| Rate for Payer: Aetna Commercial |
$300.39
|
| Rate for Payer: Aetna Medicare |
$176.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.71
|
| Rate for Payer: BCBS Complete |
$141.36
|
| Rate for Payer: Cash Price |
$282.72
|
| Rate for Payer: Cofinity Advantage |
$247.38
|
| Rate for Payer: Cofinity Commercial |
$303.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.72
|
| Rate for Payer: Healthscope Commercial |
$318.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.05
|
| Rate for Payer: PHP Commercial |
$300.39
|
| Rate for Payer: Priority Health SBD |
$222.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.71
|
| Rate for Payer: UHC Core |
$184.12
|
| Rate for Payer: UHC Exchange |
$138.89
|
| Rate for Payer: UMR Bronson Commercial |
$130.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.05
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
IP
|
$406.55
|
|
|
Service Code
|
NDC 69452015020
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.88 |
| Max. Negotiated Rate |
$365.89 |
| Rate for Payer: Aetna American Axle |
$264.26
|
| Rate for Payer: Aetna Commercial |
$345.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.26
|
| Rate for Payer: Cash Price |
$325.24
|
| Rate for Payer: Cofinity Advantage |
$284.58
|
| Rate for Payer: Cofinity Commercial |
$349.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.24
|
| Rate for Payer: Healthscope Commercial |
$365.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.91
|
| Rate for Payer: PHP Commercial |
$345.57
|
| Rate for Payer: Priority Health SBD |
$256.13
|
| Rate for Payer: UMR Bronson Commercial |
$178.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.91
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
OP
|
$406.55
|
|
|
Service Code
|
NDC 69452015020
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.42 |
| Max. Negotiated Rate |
$365.89 |
| Rate for Payer: Aetna American Axle |
$264.26
|
| Rate for Payer: Aetna Commercial |
$345.57
|
| Rate for Payer: Aetna Medicare |
$203.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.26
|
| Rate for Payer: BCBS Complete |
$162.62
|
| Rate for Payer: Cash Price |
$325.24
|
| Rate for Payer: Cofinity Advantage |
$284.58
|
| Rate for Payer: Cofinity Commercial |
$349.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.24
|
| Rate for Payer: Healthscope Commercial |
$365.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$325.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.91
|
| Rate for Payer: PHP Commercial |
$345.57
|
| Rate for Payer: Priority Health SBD |
$256.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.26
|
| Rate for Payer: UHC Core |
$211.81
|
| Rate for Payer: UHC Exchange |
$159.77
|
| Rate for Payer: UMR Bronson Commercial |
$150.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.91
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
OP
|
$386.65
|
|
|
Service Code
|
NDC 00832031011
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.06 |
| Max. Negotiated Rate |
$347.99 |
| Rate for Payer: Aetna American Axle |
$251.32
|
| Rate for Payer: Aetna Commercial |
$328.65
|
| Rate for Payer: Aetna Medicare |
$193.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.32
|
| Rate for Payer: BCBS Complete |
$154.66
|
| Rate for Payer: Cash Price |
$309.32
|
| Rate for Payer: Cofinity Advantage |
$270.65
|
| Rate for Payer: Cofinity Commercial |
$332.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.32
|
| Rate for Payer: Healthscope Commercial |
$347.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.99
|
| Rate for Payer: PHP Commercial |
$328.65
|
| Rate for Payer: Priority Health SBD |
$243.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.32
|
| Rate for Payer: UHC Core |
$201.44
|
| Rate for Payer: UHC Exchange |
$151.95
|
| Rate for Payer: UMR Bronson Commercial |
$143.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.99
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
OP
|
$319.20
|
|
|
Service Code
|
NDC 71930005712
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.10 |
| Max. Negotiated Rate |
$287.28 |
| Rate for Payer: Aetna American Axle |
$207.48
|
| Rate for Payer: Aetna Commercial |
$271.32
|
| Rate for Payer: Aetna Medicare |
$159.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.48
|
| Rate for Payer: BCBS Complete |
$127.68
|
| Rate for Payer: Cash Price |
$255.36
|
| Rate for Payer: Cofinity Advantage |
$223.44
|
| Rate for Payer: Cofinity Commercial |
$274.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.36
|
| Rate for Payer: Healthscope Commercial |
$287.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$255.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.40
|
| Rate for Payer: PHP Commercial |
$271.32
|
| Rate for Payer: Priority Health SBD |
$201.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.48
|
| Rate for Payer: UHC Core |
$166.30
|
| Rate for Payer: UHC Exchange |
$125.45
|
| Rate for Payer: UMR Bronson Commercial |
$118.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.40
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
OP
|
$293.55
|
|
|
Service Code
|
NDC 63739008610
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.61 |
| Max. Negotiated Rate |
$264.19 |
| Rate for Payer: Aetna American Axle |
$190.81
|
| Rate for Payer: Aetna Commercial |
$249.52
|
| Rate for Payer: Aetna Medicare |
$146.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.81
|
| Rate for Payer: BCBS Complete |
$117.42
|
| Rate for Payer: Cash Price |
$234.84
|
| Rate for Payer: Cofinity Advantage |
$205.49
|
| Rate for Payer: Cofinity Commercial |
$252.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.84
|
| Rate for Payer: Healthscope Commercial |
$264.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.16
|
| Rate for Payer: PHP Commercial |
$249.52
|
| Rate for Payer: Priority Health SBD |
$184.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.81
|
| Rate for Payer: UHC Core |
$152.94
|
| Rate for Payer: UHC Exchange |
$115.37
|
| Rate for Payer: UMR Bronson Commercial |
$108.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.16
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
IP
|
$353.40
|
|
|
Service Code
|
NDC 00591401201
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.50 |
| Max. Negotiated Rate |
$318.06 |
| Rate for Payer: Aetna American Axle |
$229.71
|
| Rate for Payer: Aetna Commercial |
$300.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.71
|
| Rate for Payer: Cash Price |
$282.72
|
| Rate for Payer: Cofinity Advantage |
$247.38
|
| Rate for Payer: Cofinity Commercial |
$303.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.72
|
| Rate for Payer: Healthscope Commercial |
$318.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.05
|
| Rate for Payer: PHP Commercial |
$300.39
|
| Rate for Payer: Priority Health SBD |
$222.64
|
| Rate for Payer: UMR Bronson Commercial |
$155.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.05
|
|
|
VALPROIC ACID 250 MG CAPSULE
|
Facility
|
IP
|
$319.20
|
|
|
Service Code
|
NDC 71930005712
|
| Hospital Charge Code |
8429
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.45 |
| Max. Negotiated Rate |
$287.28 |
| Rate for Payer: Aetna American Axle |
$207.48
|
| Rate for Payer: Aetna Commercial |
$271.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.48
|
| Rate for Payer: Cash Price |
$255.36
|
| Rate for Payer: Cofinity Advantage |
$223.44
|
| Rate for Payer: Cofinity Commercial |
$274.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.36
|
| Rate for Payer: Healthscope Commercial |
$287.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.40
|
| Rate for Payer: PHP Commercial |
$271.32
|
| Rate for Payer: Priority Health SBD |
$201.10
|
| Rate for Payer: UMR Bronson Commercial |
$140.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.40
|
|
|
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION
|
Facility
|
OP
|
$6.39
|
|
|
Service Code
|
NDC 00121467505
|
| Hospital Charge Code |
150931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Aetna American Axle |
$4.15
|
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.15
|
| Rate for Payer: BCBS Complete |
$2.56
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cofinity Advantage |
$4.47
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.11
|
| Rate for Payer: Healthscope Commercial |
$5.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.79
|
| Rate for Payer: PHP Commercial |
$5.43
|
| Rate for Payer: Priority Health SBD |
$4.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.15
|
| Rate for Payer: UHC Core |
$3.33
|
| Rate for Payer: UHC Exchange |
$2.51
|
| Rate for Payer: UMR Bronson Commercial |
$2.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.79
|
|
|
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION
|
Facility
|
OP
|
$1.77
|
|
|
Service Code
|
NDC 09900001951
|
| Hospital Charge Code |
150931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Aetna American Axle |
$1.15
|
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$0.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.15
|
| Rate for Payer: BCBS Complete |
$0.71
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Advantage |
$1.24
|
| Rate for Payer: Cofinity Commercial |
$1.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Healthscope Commercial |
$1.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.33
|
| Rate for Payer: PHP Commercial |
$1.50
|
| Rate for Payer: Priority Health SBD |
$1.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.15
|
| Rate for Payer: UHC Core |
$0.92
|
| Rate for Payer: UHC Exchange |
$0.70
|
| Rate for Payer: UMR Bronson Commercial |
$0.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION
|
Facility
|
IP
|
$6.39
|
|
|
Service Code
|
NDC 00121467505
|
| Hospital Charge Code |
150931
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Aetna American Axle |
$4.15
|
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.15
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cofinity Advantage |
$4.47
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.11
|
| Rate for Payer: Healthscope Commercial |
$5.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.79
|
| Rate for Payer: PHP Commercial |
$5.43
|
| Rate for Payer: Priority Health SBD |
$4.03
|
| Rate for Payer: UMR Bronson Commercial |
$2.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.79
|
|
