|
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
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$45.24
|
|
|
Service Code
|
NDC 47335093240
|
| 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
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| 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
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$45.24
|
|
|
Service Code
|
NDC 47335093240
|
| 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
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26,282.62
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11,564.35 |
| Max. Negotiated Rate |
$23,654.36 |
| Rate for Payer: Aetna American Axle |
$17,083.70
|
| Rate for Payer: Aetna Commercial |
$22,340.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,083.70
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cofinity Advantage |
$18,397.83
|
| Rate for Payer: Cofinity Commercial |
$22,603.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,026.10
|
| Rate for Payer: Healthscope Commercial |
$23,654.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,397.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,711.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,340.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,711.97
|
| Rate for Payer: PHP Commercial |
$22,340.23
|
| Rate for Payer: Priority Health SBD |
$16,558.05
|
| Rate for Payer: UMR Bronson Commercial |
$11,564.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,711.97
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26,282.62
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$23,654.36 |
| Rate for Payer: Aetna American Axle |
$17,083.70
|
| Rate for Payer: Aetna Commercial |
$22,340.23
|
| Rate for Payer: Aetna Medicare |
$21.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,083.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.23
|
| Rate for Payer: BCBS Complete |
$11.52
|
| Rate for Payer: BCBS MAPPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$69.29
|
| Rate for Payer: BCN Commercial |
$69.29
|
| Rate for Payer: BCN Medicare Advantage |
$20.98
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cofinity Advantage |
$18,397.83
|
| Rate for Payer: Cofinity Commercial |
$22,603.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,026.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.98
|
| Rate for Payer: Healthscope Commercial |
$23,654.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,397.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,711.97
|
| Rate for Payer: Mclaren Medicaid |
$20.98
|
| Rate for Payer: Mclaren Medicare |
$20.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.03
|
| Rate for Payer: Meridian Medicaid |
$22.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,340.23
|
| Rate for Payer: Nomi Health Commercial |
$62.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,711.97
|
| Rate for Payer: PACE Medicare |
$19.93
|
| Rate for Payer: PACE SWMI |
$20.98
|
| Rate for Payer: PHP Commercial |
$22,340.23
|
| Rate for Payer: PHP Medicare Advantage |
$20.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.21
|
| Rate for Payer: Priority Health Medicare |
$20.98
|
| Rate for Payer: Priority Health SBD |
$16,558.05
|
| Rate for Payer: Priority Health Tiered Network |
$53.77
|
| Rate for Payer: Railroad Medicare Medicare |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.26
|
| Rate for Payer: UHC Core |
$35.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.98
|
| Rate for Payer: UHC Exchange |
$35.26
|
| Rate for Payer: UHC Medicaid |
$10.97
|
| Rate for Payer: UHCCP Medicaid |
$10.97
|
| Rate for Payer: UMR Bronson Commercial |
$9,724.57
|
| Rate for Payer: VA VA |
$20.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,711.97
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$62,849.06
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$24,853.02 |
| Max. Negotiated Rate |
$62,849.06 |
| Rate for Payer: Aetna Medicare |
$27,207.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,701.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,701.34
|
| Rate for Payer: BCBS MAPPO |
$26,161.07
|
| Rate for Payer: BCBS Trust/PPO |
$62,849.06
|
| Rate for Payer: BCN Commercial |
$62,849.06
|
| Rate for Payer: BCN Medicare Advantage |
$26,161.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,161.07
|
| Rate for Payer: Mclaren Medicare |
$26,161.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,469.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,085.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,777.18
|
| Rate for Payer: Nomi Health Commercial |
$39,440.46
|
| Rate for Payer: PACE Medicare |
$24,853.02
|
| Rate for Payer: PACE SWMI |
$26,161.07
|
| Rate for Payer: PHP Medicare Advantage |
$26,161.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49,291.83
|
| Rate for Payer: Priority Health Medicare |
$26,161.07
|
| Rate for Payer: Priority Health Tiered Network |
$39,433.46
|
| Rate for Payer: Railroad Medicare Medicare |
$26,161.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,835.62
|
| Rate for Payer: UHC Core |
$41,693.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,161.07
|
| Rate for Payer: UHC Exchange |
$34,050.26
|
| Rate for Payer: VA VA |
$26,161.07
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
IP
|
$495.99
|
|
|
Service Code
|
NDC 00074057611
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$218.24 |
| Max. Negotiated Rate |
$446.39 |
| Rate for Payer: Aetna American Axle |
$322.39
|
| Rate for Payer: Aetna Commercial |
$421.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.39
|
| Rate for Payer: Cash Price |
$396.79
|
| Rate for Payer: Cofinity Advantage |
$347.19
|
| Rate for Payer: Cofinity Commercial |
$426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.79
|
| Rate for Payer: Healthscope Commercial |
$446.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.99
|
| Rate for Payer: PHP Commercial |
$421.59
|
| Rate for Payer: Priority Health SBD |
$312.47
|
| Rate for Payer: UMR Bronson Commercial |
$218.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.99
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
IP
|
$13,889.35
|
|
|
Service Code
|
NDC 00074057630
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6,111.31 |
| Max. Negotiated Rate |
$12,500.42 |
| Rate for Payer: Aetna American Axle |
$9,028.08
|
| Rate for Payer: Aetna Commercial |
$11,805.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,028.08
|
| Rate for Payer: Cash Price |
$11,111.48
|
| Rate for Payer: Cofinity Advantage |
$9,722.55
|
| Rate for Payer: Cofinity Commercial |
$11,944.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,111.48
|
| Rate for Payer: Healthscope Commercial |
$12,500.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,722.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,417.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,805.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,417.01
|
| Rate for Payer: PHP Commercial |
$11,805.95
|
| Rate for Payer: Priority Health SBD |
$8,750.29
|
| Rate for Payer: UMR Bronson Commercial |
$6,111.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,417.01
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
OP
|
$13,889.35
|
|
|
Service Code
|
NDC 00074057630
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,139.06 |
| Max. Negotiated Rate |
$12,500.42 |
| Rate for Payer: Aetna American Axle |
$9,028.08
|
| Rate for Payer: Aetna Commercial |
$11,805.95
|
| Rate for Payer: Aetna Medicare |
$6,944.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,028.08
|
| Rate for Payer: BCBS Complete |
$5,555.74
|
| Rate for Payer: Cash Price |
$11,111.48
|
| Rate for Payer: Cofinity Advantage |
$9,722.55
|
| Rate for Payer: Cofinity Commercial |
$11,944.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,111.48
|
| Rate for Payer: Healthscope Commercial |
$12,500.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,722.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,417.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,111.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,805.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,417.01
|
| Rate for Payer: PHP Commercial |
$11,805.95
|
| Rate for Payer: Priority Health SBD |
$8,750.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,028.08
|
| Rate for Payer: UHC Core |
$7,236.35
|
| Rate for Payer: UHC Exchange |
$5,458.51
|
| Rate for Payer: UMR Bronson Commercial |
$5,139.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,417.01
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
OP
|
$495.99
|
|
|
Service Code
|
NDC 00074057611
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$183.52 |
| Max. Negotiated Rate |
$446.39 |
| Rate for Payer: Aetna American Axle |
$322.39
|
| Rate for Payer: Aetna Commercial |
$421.59
|
| Rate for Payer: Aetna Medicare |
$248.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.39
|
| Rate for Payer: BCBS Complete |
$198.40
|
| Rate for Payer: Cash Price |
$396.79
|
| Rate for Payer: Cofinity Advantage |
$347.19
|
| Rate for Payer: Cofinity Commercial |
$426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.79
|
| Rate for Payer: Healthscope Commercial |
$446.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$396.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.99
|
| Rate for Payer: PHP Commercial |
$421.59
|
| Rate for Payer: Priority Health SBD |
$312.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.39
|
| Rate for Payer: UHC Core |
$258.41
|
| Rate for Payer: UHC Exchange |
$194.92
|
| Rate for Payer: UMR Bronson Commercial |
$183.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.99
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
|
OP
|
$99.16
|
|
|
Service Code
|
NDC 00074056111
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.69 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna American Axle |
$64.45
|
| Rate for Payer: Aetna Commercial |
$84.29
|
| Rate for Payer: Aetna Medicare |
$49.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.45
|
| Rate for Payer: BCBS Complete |
$39.66
|
| Rate for Payer: Cash Price |
$79.33
|
| Rate for Payer: Cofinity Advantage |
$69.41
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.33
|
| Rate for Payer: Healthscope Commercial |
$89.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.37
|
| Rate for Payer: PHP Commercial |
$84.29
|
| Rate for Payer: Priority Health SBD |
$62.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$51.66
|
| Rate for Payer: UHC Exchange |
$38.97
|
| Rate for Payer: UMR Bronson Commercial |
$36.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.37
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
|
OP
|
$694.49
|
|
|
Service Code
|
NDC 00074056114
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$256.96 |
| Max. Negotiated Rate |
$625.04 |
| Rate for Payer: Aetna American Axle |
$451.42
|
| Rate for Payer: Aetna Commercial |
$590.32
|
| Rate for Payer: Aetna Medicare |
$347.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.42
|
| Rate for Payer: BCBS Complete |
$277.80
|
| Rate for Payer: Cash Price |
$555.59
|
| Rate for Payer: Cofinity Advantage |
$486.14
|
| Rate for Payer: Cofinity Commercial |
$597.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.59
|
| Rate for Payer: Healthscope Commercial |
$625.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$486.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$555.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$590.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.87
|
| Rate for Payer: PHP Commercial |
$590.32
|
| Rate for Payer: Priority Health SBD |
$437.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.42
|
| Rate for Payer: UHC Core |
$361.83
|
| Rate for Payer: UHC Exchange |
$272.93
|
| Rate for Payer: UMR Bronson Commercial |
$256.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.87
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
|
IP
|
$694.49
|
|
|
Service Code
|
NDC 00074056114
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$305.58 |
| Max. Negotiated Rate |
$625.04 |
| Rate for Payer: Aetna American Axle |
$451.42
|
| Rate for Payer: Aetna Commercial |
$590.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.42
|
| Rate for Payer: Cash Price |
$555.59
|
| Rate for Payer: Cofinity Advantage |
$486.14
|
| Rate for Payer: Cofinity Commercial |
$597.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.59
|
| Rate for Payer: Healthscope Commercial |
$625.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$486.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$590.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.87
|
| Rate for Payer: PHP Commercial |
$590.32
|
| Rate for Payer: Priority Health SBD |
$437.53
|
| Rate for Payer: UMR Bronson Commercial |
$305.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.87
|
|
|
VENETOCLAX 10 MG TABLET
|
Facility
|
IP
|
$99.16
|
|
|
Service Code
|
NDC 00074056111
|
| Hospital Charge Code |
178561
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.63 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna American Axle |
$64.45
|
| Rate for Payer: Aetna Commercial |
$84.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.45
|
| Rate for Payer: Cash Price |
$79.33
|
| Rate for Payer: Cofinity Advantage |
$69.41
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.33
|
| Rate for Payer: Healthscope Commercial |
$89.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.37
|
| Rate for Payer: PHP Commercial |
$84.29
|
| Rate for Payer: Priority Health SBD |
$62.47
|
| Rate for Payer: UMR Bronson Commercial |
$43.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.37
|
|
|
VENETOCLAX 50 MG TABLET
|
Facility
|
OP
|
$248.05
|
|
|
Service Code
|
NDC 00074056611
|
| Hospital Charge Code |
178562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.78 |
| Max. Negotiated Rate |
$223.25 |
| Rate for Payer: Aetna American Axle |
$161.23
|
| Rate for Payer: Aetna Commercial |
$210.84
|
| Rate for Payer: Aetna Medicare |
$124.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.23
|
| Rate for Payer: BCBS Complete |
$99.22
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cofinity Advantage |
$173.63
|
| Rate for Payer: Cofinity Commercial |
$213.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.44
|
| Rate for Payer: Healthscope Commercial |
$223.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.04
|
| Rate for Payer: PHP Commercial |
$210.84
|
| Rate for Payer: Priority Health SBD |
$156.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.23
|
| Rate for Payer: UHC Core |
$129.23
|
| Rate for Payer: UHC Exchange |
$97.48
|
| Rate for Payer: UMR Bronson Commercial |
$91.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.04
|
|
|
VENETOCLAX 50 MG TABLET
|
Facility
|
IP
|
$248.05
|
|
|
Service Code
|
NDC 00074056611
|
| Hospital Charge Code |
178562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$223.25 |
| Rate for Payer: Aetna American Axle |
$161.23
|
| Rate for Payer: Aetna Commercial |
$210.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.23
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cofinity Advantage |
$173.63
|
| Rate for Payer: Cofinity Commercial |
$213.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.44
|
| Rate for Payer: Healthscope Commercial |
$223.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.04
|
| Rate for Payer: PHP Commercial |
$210.84
|
| Rate for Payer: Priority Health SBD |
$156.27
|
| Rate for Payer: UMR Bronson Commercial |
$109.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.04
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$291.65
|
|
|
Service Code
|
NDC 68382001901
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$262.49 |
| Rate for Payer: Aetna American Axle |
$189.57
|
| Rate for Payer: Aetna Commercial |
$247.90
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.57
|
| Rate for Payer: BCBS Complete |
$116.66
|
| Rate for Payer: Cash Price |
$233.32
|
| Rate for Payer: Cofinity Advantage |
$204.16
|
| Rate for Payer: Cofinity Commercial |
$250.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.32
|
| Rate for Payer: Healthscope Commercial |
$262.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.74
|
| Rate for Payer: PHP Commercial |
$247.90
|
| Rate for Payer: Priority Health SBD |
$183.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.57
|
| Rate for Payer: UHC Core |
$151.95
|
| Rate for Payer: UHC Exchange |
$114.62
|
| Rate for Payer: UMR Bronson Commercial |
$107.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.74
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna Medicare |
$1.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.72
|
| Rate for Payer: UHC Core |
$1.38
|
| Rate for Payer: UHC Exchange |
$1.04
|
| Rate for Payer: UMR Bronson Commercial |
$0.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$291.65
|
|
|
Service Code
|
NDC 68382001901
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.33 |
| Max. Negotiated Rate |
$262.49 |
| Rate for Payer: Aetna American Axle |
$189.57
|
| Rate for Payer: Aetna Commercial |
$247.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.57
|
| Rate for Payer: Cash Price |
$233.32
|
| Rate for Payer: Cofinity Advantage |
$204.16
|
| Rate for Payer: Cofinity Commercial |
$250.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.32
|
| Rate for Payer: Healthscope Commercial |
$262.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.74
|
| Rate for Payer: PHP Commercial |
$247.90
|
| Rate for Payer: Priority Health SBD |
$183.74
|
| Rate for Payer: UMR Bronson Commercial |
$128.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.74
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
VENLAFAXINE 50 MG TABLET
|
Facility
|
IP
|
$286.90
|
|
|
Service Code
|
NDC 62332001031
|
| Hospital Charge Code |
12204
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.24 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna American Axle |
$186.49
|
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.49
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Advantage |
$200.83
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: Priority Health SBD |
$180.75
|
| Rate for Payer: UMR Bronson Commercial |
$126.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
VENLAFAXINE 50 MG TABLET
|
Facility
|
OP
|
$300.20
|
|
|
Service Code
|
NDC 68382002001
|
| Hospital Charge Code |
12204
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna Medicare |
$150.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: BCBS Complete |
$120.08
|
| Rate for Payer: Cash Price |
$240.16
|
| Rate for Payer: Cofinity Advantage |
$210.14
|
| Rate for Payer: Cofinity Commercial |
$258.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$270.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.15
|
| Rate for Payer: PHP Commercial |
$255.17
|
| Rate for Payer: Priority Health SBD |
$189.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.13
|
| Rate for Payer: UHC Core |
$156.40
|
| Rate for Payer: UHC Exchange |
$117.98
|
| Rate for Payer: UMR Bronson Commercial |
$111.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
|
VENLAFAXINE 50 MG TABLET
|
Facility
|
IP
|
$230.30
|
|
|
Service Code
|
NDC 57237017401
|
| Hospital Charge Code |
12204
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.33 |
| Max. Negotiated Rate |
$207.27 |
| Rate for Payer: Aetna American Axle |
$149.69
|
| Rate for Payer: Aetna Commercial |
$195.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.69
|
| Rate for Payer: Cash Price |
$184.24
|
| Rate for Payer: Cofinity Advantage |
$161.21
|
| Rate for Payer: Cofinity Commercial |
$198.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.24
|
| Rate for Payer: Healthscope Commercial |
$207.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.72
|
| Rate for Payer: PHP Commercial |
$195.75
|
| Rate for Payer: Priority Health SBD |
$145.09
|
| Rate for Payer: UMR Bronson Commercial |
$101.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.72
|
|
|
VENLAFAXINE 50 MG TABLET
|
Facility
|
OP
|
$300.20
|
|
|
Service Code
|
NDC 57664039488
|
| Hospital Charge Code |
12204
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna Medicare |
$150.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: BCBS Complete |
$120.08
|
| Rate for Payer: Cash Price |
$240.16
|
| Rate for Payer: Cofinity Advantage |
$210.14
|
| Rate for Payer: Cofinity Commercial |
$258.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$270.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.15
|
| Rate for Payer: PHP Commercial |
$255.17
|
| Rate for Payer: Priority Health SBD |
$189.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.13
|
| Rate for Payer: UHC Core |
$156.40
|
| Rate for Payer: UHC Exchange |
$117.98
|
| Rate for Payer: UMR Bronson Commercial |
$111.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
