|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$41.76
|
|
|
Service Code
|
NDC 00143923210
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$37.58 |
| Rate for Payer: Aetna American Axle |
$27.14
|
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.14
|
| Rate for Payer: Cash Price |
$33.41
|
| Rate for Payer: Cofinity Advantage |
$29.23
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.41
|
| Rate for Payer: Healthscope Commercial |
$37.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.32
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health SBD |
$26.31
|
| Rate for Payer: UMR Bronson Commercial |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.32
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.49
|
|
|
Service Code
|
NDC 55150023621
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna Medicare |
$10.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: BCBS Complete |
$8.20
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Advantage |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.37
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.32
|
| Rate for Payer: UHC Core |
$10.68
|
| Rate for Payer: UHC Exchange |
$8.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.49
|
|
|
Service Code
|
NDC 55150023602
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna Medicare |
$10.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: BCBS Complete |
$8.20
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Advantage |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.37
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.32
|
| Rate for Payer: UHC Core |
$10.68
|
| Rate for Payer: UHC Exchange |
$8.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.18
|
|
|
Service Code
|
NDC 67457047500
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.76 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$47.18
|
|
|
Service Code
|
NDC 67457047520
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna Medicare |
$23.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.67
|
| Rate for Payer: UHC Core |
$24.58
|
| Rate for Payer: UHC Exchange |
$18.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$41.76
|
|
|
Service Code
|
NDC 00143923201
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$37.58 |
| Rate for Payer: Aetna American Axle |
$27.14
|
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.14
|
| Rate for Payer: Cash Price |
$33.41
|
| Rate for Payer: Cofinity Advantage |
$29.23
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.41
|
| Rate for Payer: Healthscope Commercial |
$37.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.32
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health SBD |
$26.31
|
| Rate for Payer: UMR Bronson Commercial |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.32
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$34.17
|
|
|
Service Code
|
NDC 00409163485
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$17.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: BCBS Complete |
$13.67
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Advantage |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.63
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.21
|
| Rate for Payer: UHC Core |
$17.80
|
| Rate for Payer: UHC Exchange |
$13.43
|
| Rate for Payer: UMR Bronson Commercial |
$12.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$34.17
|
|
|
Service Code
|
NDC 00409163485
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Advantage |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.63
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.24
|
|
|
Service Code
|
NDC 47335093240
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.74 |
| Max. Negotiated Rate |
$40.72 |
| Rate for Payer: Aetna American Axle |
$29.41
|
| Rate for Payer: Aetna Commercial |
$38.45
|
| Rate for Payer: Aetna Medicare |
$22.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.41
|
| Rate for Payer: BCBS Complete |
$18.10
|
| Rate for Payer: Cash Price |
$36.19
|
| Rate for Payer: Cofinity Advantage |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$38.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.19
|
| Rate for Payer: Healthscope Commercial |
$40.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.93
|
| Rate for Payer: PHP Commercial |
$38.45
|
| Rate for Payer: Priority Health SBD |
$28.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.41
|
| Rate for Payer: UHC Core |
$23.57
|
| Rate for Payer: UHC Exchange |
$17.78
|
| Rate for Payer: UMR Bronson Commercial |
$16.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.93
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.49
|
|
|
Service Code
|
NDC 55150023621
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Advantage |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.37
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.18
|
|
|
Service Code
|
NDC 67457047520
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.76 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
NDC 63323078220
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$24.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: BCBS Complete |
$19.95
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.42
|
| Rate for Payer: UHC Core |
$25.99
|
| Rate for Payer: UHC Exchange |
$19.60
|
| Rate for Payer: UMR Bronson Commercial |
$18.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.49
|
|
|
Service Code
|
NDC 55150023602
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Advantage |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.37
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.08
|
|
|
Service Code
|
NDC 55150023601
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna American Axle |
$13.05
|
| Rate for Payer: Aetna Commercial |
$17.07
|
| Rate for Payer: Aetna Medicare |
$10.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: BCBS Complete |
$8.03
|
| Rate for Payer: Cash Price |
$16.06
|
| Rate for Payer: Cofinity Advantage |
$14.06
|
| Rate for Payer: Cofinity Commercial |
$17.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.06
|
| Rate for Payer: PHP Commercial |
$17.07
|
| Rate for Payer: Priority Health SBD |
$12.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.05
|
| Rate for Payer: UHC Core |
$10.46
|
| Rate for Payer: UHC Exchange |
$7.89
|
| Rate for Payer: UMR Bronson Commercial |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.06
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
NDC 63323078220
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna Medicare |
$35.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: BCBS Complete |
$28.75
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Advantage |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.90
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.72
|
| Rate for Payer: UHC Core |
$37.44
|
| Rate for Payer: UHC Exchange |
$28.24
|
| Rate for Payer: UMR Bronson Commercial |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$47.18
|
|
|
Service Code
|
NDC 67457047500
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna Medicare |
$23.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.67
|
| Rate for Payer: UHC Core |
$24.58
|
| Rate for Payer: UHC Exchange |
$18.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$45.24
|
|
|
Service Code
|
NDC 47335093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$40.72 |
| Rate for Payer: Aetna American Axle |
$29.41
|
| Rate for Payer: Aetna Commercial |
$38.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.41
|
| Rate for Payer: Cash Price |
$36.19
|
| Rate for Payer: Cofinity Advantage |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$38.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.19
|
| Rate for Payer: Healthscope Commercial |
$40.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.93
|
| Rate for Payer: PHP Commercial |
$38.45
|
| Rate for Payer: Priority Health SBD |
$28.50
|
| Rate for Payer: UMR Bronson Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.93
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Advantage |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.90
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$71.87
|
|
|
Service Code
|
NDC 41616093240
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna Medicare |
$35.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: BCBS Complete |
$28.75
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Advantage |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.90
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.72
|
| Rate for Payer: UHC Core |
$37.44
|
| Rate for Payer: UHC Exchange |
$28.24
|
| Rate for Payer: UMR Bronson Commercial |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$41.76
|
|
|
Service Code
|
NDC 00143923201
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$37.58 |
| Rate for Payer: Aetna American Axle |
$27.14
|
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna Medicare |
$20.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.14
|
| Rate for Payer: BCBS Complete |
$16.70
|
| Rate for Payer: Cash Price |
$33.41
|
| Rate for Payer: Cofinity Advantage |
$29.23
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.41
|
| Rate for Payer: Healthscope Commercial |
$37.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.32
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health SBD |
$26.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.14
|
| Rate for Payer: UHC Core |
$21.76
|
| Rate for Payer: UHC Exchange |
$16.41
|
| Rate for Payer: UMR Bronson Commercial |
$15.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.32
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$45.24
|
|
|
Service Code
|
NDC 47335093244
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$40.72 |
| Rate for Payer: Aetna American Axle |
$29.41
|
| Rate for Payer: Aetna Commercial |
$38.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.41
|
| Rate for Payer: Cash Price |
$36.19
|
| Rate for Payer: Cofinity Advantage |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$38.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.19
|
| Rate for Payer: Healthscope Commercial |
$40.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.93
|
| Rate for Payer: PHP Commercial |
$38.45
|
| Rate for Payer: Priority Health SBD |
$28.50
|
| Rate for Payer: UMR Bronson Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.93
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$45.24
|
|
|
Service Code
|
NDC 47335093244
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.74 |
| Max. Negotiated Rate |
$40.72 |
| Rate for Payer: Aetna American Axle |
$29.41
|
| Rate for Payer: Aetna Commercial |
$38.45
|
| Rate for Payer: Aetna Medicare |
$22.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.41
|
| Rate for Payer: BCBS Complete |
$18.10
|
| Rate for Payer: Cash Price |
$36.19
|
| Rate for Payer: Cofinity Advantage |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$38.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.19
|
| Rate for Payer: Healthscope Commercial |
$40.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.93
|
| Rate for Payer: PHP Commercial |
$38.45
|
| Rate for Payer: Priority Health SBD |
$28.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.41
|
| Rate for Payer: UHC Core |
$23.57
|
| Rate for Payer: UHC Exchange |
$17.78
|
| Rate for Payer: UMR Bronson Commercial |
$16.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.93
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616093240
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Advantage |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.90
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$71.87
|
|
|
Service Code
|
NDC 41616093240
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna Medicare |
$35.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: BCBS Complete |
$28.75
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Advantage |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.90
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.72
|
| Rate for Payer: UHC Core |
$37.44
|
| Rate for Payer: UHC Exchange |
$28.24
|
| Rate for Payer: UMR Bronson Commercial |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
