|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,982.13
|
|
|
Service Code
|
NDC 00008083321
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$733.39 |
| Max. Negotiated Rate |
$1,783.92 |
| Rate for Payer: Aetna American Axle |
$1,288.38
|
| Rate for Payer: Aetna Commercial |
$1,684.81
|
| Rate for Payer: Aetna Medicare |
$991.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.38
|
| Rate for Payer: BCBS Complete |
$792.85
|
| Rate for Payer: Cash Price |
$1,585.70
|
| Rate for Payer: Cofinity Advantage |
$1,387.49
|
| Rate for Payer: Cofinity Commercial |
$1,704.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.70
|
| Rate for Payer: Healthscope Commercial |
$1,783.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,387.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,486.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,585.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,486.60
|
| Rate for Payer: PHP Commercial |
$1,684.81
|
| Rate for Payer: Priority Health SBD |
$1,248.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.38
|
| Rate for Payer: UHC Core |
$1,032.69
|
| Rate for Payer: UHC Exchange |
$778.98
|
| Rate for Payer: UMR Bronson Commercial |
$733.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,486.60
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$226.58
|
|
|
Service Code
|
NDC 00093738598
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.83 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna American Axle |
$147.28
|
| Rate for Payer: Aetna Commercial |
$192.59
|
| Rate for Payer: Aetna Medicare |
$113.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.28
|
| Rate for Payer: BCBS Complete |
$90.63
|
| Rate for Payer: Cash Price |
$181.26
|
| Rate for Payer: Cofinity Advantage |
$158.61
|
| Rate for Payer: Cofinity Commercial |
$194.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.26
|
| Rate for Payer: Healthscope Commercial |
$203.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.94
|
| Rate for Payer: PHP Commercial |
$192.59
|
| Rate for Payer: Priority Health SBD |
$142.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.28
|
| Rate for Payer: UHC Core |
$118.05
|
| Rate for Payer: UHC Exchange |
$89.05
|
| Rate for Payer: UMR Bronson Commercial |
$83.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.94
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$2.81
|
|
|
Service Code
|
NDC 68084070911
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Aetna American Axle |
$1.83
|
| Rate for Payer: Aetna Commercial |
$2.39
|
| Rate for Payer: Aetna Medicare |
$1.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.83
|
| Rate for Payer: BCBS Complete |
$1.12
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: Cofinity Advantage |
$1.97
|
| Rate for Payer: Cofinity Commercial |
$2.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$2.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.11
|
| Rate for Payer: PHP Commercial |
$2.39
|
| Rate for Payer: Priority Health SBD |
$1.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.46
|
| Rate for Payer: UHC Exchange |
$1.10
|
| Rate for Payer: UMR Bronson Commercial |
$1.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.11
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$226.58
|
|
|
Service Code
|
NDC 00093738598
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.70 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna American Axle |
$147.28
|
| Rate for Payer: Aetna Commercial |
$192.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.28
|
| Rate for Payer: Cash Price |
$181.26
|
| Rate for Payer: Cofinity Advantage |
$158.61
|
| Rate for Payer: Cofinity Commercial |
$194.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.26
|
| Rate for Payer: Healthscope Commercial |
$203.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.94
|
| Rate for Payer: PHP Commercial |
$192.59
|
| Rate for Payer: Priority Health SBD |
$142.75
|
| Rate for Payer: UMR Bronson Commercial |
$99.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.94
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$75.44
|
|
|
Service Code
|
NDC 65862052830
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.91 |
| Max. Negotiated Rate |
$67.90 |
| Rate for Payer: Aetna American Axle |
$49.04
|
| Rate for Payer: Aetna Commercial |
$64.12
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.04
|
| Rate for Payer: BCBS Complete |
$30.18
|
| Rate for Payer: Cash Price |
$60.35
|
| Rate for Payer: Cofinity Advantage |
$52.81
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.35
|
| Rate for Payer: Healthscope Commercial |
$67.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.58
|
| Rate for Payer: PHP Commercial |
$64.12
|
| Rate for Payer: Priority Health SBD |
$47.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.04
|
| Rate for Payer: UHC Core |
$39.30
|
| Rate for Payer: UHC Exchange |
$29.65
|
| Rate for Payer: UMR Bronson Commercial |
$27.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.58
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$75.44
|
|
|
Service Code
|
NDC 65862052830
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.19 |
| Max. Negotiated Rate |
$67.90 |
| Rate for Payer: Aetna American Axle |
$49.04
|
| Rate for Payer: Aetna Commercial |
$64.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.04
|
| Rate for Payer: Cash Price |
$60.35
|
| Rate for Payer: Cofinity Advantage |
$52.81
|
| Rate for Payer: Cofinity Commercial |
$64.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.35
|
| Rate for Payer: Healthscope Commercial |
$67.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.58
|
| Rate for Payer: PHP Commercial |
$64.12
|
| Rate for Payer: Priority Health SBD |
$47.53
|
| Rate for Payer: UMR Bronson Commercial |
$33.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.58
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$280.32
|
|
|
Service Code
|
NDC 68084070901
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.34 |
| Max. Negotiated Rate |
$252.29 |
| Rate for Payer: Aetna American Axle |
$182.21
|
| Rate for Payer: Aetna Commercial |
$238.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.21
|
| Rate for Payer: Cash Price |
$224.26
|
| Rate for Payer: Cofinity Advantage |
$196.22
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.26
|
| Rate for Payer: Healthscope Commercial |
$252.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.24
|
| Rate for Payer: PHP Commercial |
$238.27
|
| Rate for Payer: Priority Health SBD |
$176.60
|
| Rate for Payer: UMR Bronson Commercial |
$123.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.24
|
|
|
VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA
|
Facility
|
OP
|
$10,683.35
|
|
|
Service Code
|
CPT 69424
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,855.02
|
| Rate for Payer: BCN Commercial |
$3,855.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna Medicare |
$33.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: BCBS Complete |
$26.71
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Advantage |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.09
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.41
|
| Rate for Payer: UHC Core |
$34.79
|
| Rate for Payer: UHC Exchange |
$26.24
|
| Rate for Payer: UMR Bronson Commercial |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$66.78
|
|
|
Service Code
|
NDC 173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna Medicare |
$33.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: BCBS Complete |
$26.71
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Advantage |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.09
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.41
|
| Rate for Payer: UHC Core |
$34.79
|
| Rate for Payer: UHC Exchange |
$26.24
|
| Rate for Payer: UMR Bronson Commercial |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.38 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Advantage |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.09
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UMR Bronson Commercial |
$29.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$10,084.11
|
|
|
Service Code
|
APR-DRG 0223
|
| Min. Negotiated Rate |
$9,603.91 |
| Max. Negotiated Rate |
$10,084.11 |
| Rate for Payer: BCBS Complete |
$10,084.11
|
| Rate for Payer: Mclaren Medicaid |
$9,603.91
|
| Rate for Payer: Meridian Medicaid |
$10,084.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,603.91
|
| Rate for Payer: UHC Medicaid |
$9,603.91
|
| Rate for Payer: UHCCP Medicaid |
$9,603.91
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$9,334.11
|
|
|
Service Code
|
APR-DRG 0221
|
| Min. Negotiated Rate |
$8,889.63 |
| Max. Negotiated Rate |
$9,334.11 |
| Rate for Payer: BCBS Complete |
$9,334.11
|
| Rate for Payer: Mclaren Medicaid |
$8,889.63
|
| Rate for Payer: Meridian Medicaid |
$9,334.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,889.63
|
| Rate for Payer: UHC Medicaid |
$8,889.63
|
| Rate for Payer: UHCCP Medicaid |
$8,889.63
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$25,355.85
|
|
|
Service Code
|
APR-DRG 0224
|
| Min. Negotiated Rate |
$24,148.43 |
| Max. Negotiated Rate |
$25,355.85 |
| Rate for Payer: BCBS Complete |
$25,355.85
|
| Rate for Payer: Mclaren Medicaid |
$24,148.43
|
| Rate for Payer: Meridian Medicaid |
$25,355.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,148.43
|
| Rate for Payer: UHC Medicaid |
$24,148.43
|
| Rate for Payer: UHCCP Medicaid |
$24,148.43
|
|
|
VENTRICULAR SHUNT PROCEDURES
|
Facility
|
IP
|
$9,425.52
|
|
|
Service Code
|
APR-DRG 0222
|
| Min. Negotiated Rate |
$8,976.68 |
| Max. Negotiated Rate |
$9,425.52 |
| Rate for Payer: BCBS Complete |
$9,425.52
|
| Rate for Payer: Mclaren Medicaid |
$8,976.68
|
| Rate for Payer: Meridian Medicaid |
$9,425.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,976.68
|
| Rate for Payer: UHC Medicaid |
$8,976.68
|
| Rate for Payer: UHCCP Medicaid |
$8,976.68
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$46,661.21
|
|
|
Service Code
|
MSDRG 032
|
| Min. Negotiated Rate |
$17,493.19 |
| Max. Negotiated Rate |
$46,661.21 |
| Rate for Payer: Aetna Medicare |
$19,150.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,017.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,017.35
|
| Rate for Payer: BCBS MAPPO |
$18,413.88
|
| Rate for Payer: BCBS Trust/PPO |
$46,661.21
|
| Rate for Payer: BCN Commercial |
$46,661.21
|
| Rate for Payer: BCN Medicare Advantage |
$18,413.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,413.88
|
| Rate for Payer: Mclaren Medicare |
$18,413.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,334.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,175.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,255.27
|
| Rate for Payer: Nomi Health Commercial |
$27,489.90
|
| Rate for Payer: PACE Medicare |
$17,493.19
|
| Rate for Payer: PACE SWMI |
$18,413.88
|
| Rate for Payer: PHP Medicare Advantage |
$18,413.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,356.28
|
| Rate for Payer: Priority Health Medicare |
$18,413.88
|
| Rate for Payer: Priority Health Tiered Network |
$27,485.02
|
| Rate for Payer: Railroad Medicare Medicare |
$18,413.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,735.30
|
| Rate for Payer: UHC Core |
$29,060.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,413.88
|
| Rate for Payer: UHC Exchange |
$23,732.95
|
| Rate for Payer: VA VA |
$18,413.88
|
|
|
VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$108,760.86
|
|
|
Service Code
|
MSDRG 031
|
| Min. Negotiated Rate |
$36,158.91 |
| Max. Negotiated Rate |
$108,760.86 |
| Rate for Payer: Aetna Medicare |
$39,584.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47,577.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47,577.51
|
| Rate for Payer: BCBS MAPPO |
$38,062.01
|
| Rate for Payer: BCBS Trust/PPO |
$108,760.86
|
| Rate for Payer: BCN Commercial |
$108,760.86
|
| Rate for Payer: BCN Medicare Advantage |
$38,062.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,062.01
|
| Rate for Payer: Mclaren Medicare |
$38,062.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39,965.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43,771.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$41,868.21
|
| Rate for Payer: Nomi Health Commercial |
$57,798.45
|
| Rate for Payer: PACE Medicare |
$36,158.91
|
| Rate for Payer: PACE SWMI |
$38,062.01
|
| Rate for Payer: PHP Medicare Advantage |
$38,062.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72,235.25
|
| Rate for Payer: Priority Health Medicare |
$38,062.01
|
| Rate for Payer: Priority Health Tiered Network |
$57,788.19
|
| Rate for Payer: Railroad Medicare Medicare |
$38,062.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73,032.15
|
| Rate for Payer: UHC Core |
$61,100.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38,062.01
|
| Rate for Payer: UHC Exchange |
$49,899.33
|
| Rate for Payer: VA VA |
$38,062.01
|
|
|
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,664.34
|
|
|
Service Code
|
MSDRG 033
|
| Min. Negotiated Rate |
$13,774.33 |
| Max. Negotiated Rate |
$42,664.34 |
| Rate for Payer: Aetna Medicare |
$15,079.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,124.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,124.11
|
| Rate for Payer: BCBS MAPPO |
$14,499.29
|
| Rate for Payer: BCBS Trust/PPO |
$42,664.34
|
| Rate for Payer: BCN Commercial |
$42,664.34
|
| Rate for Payer: BCN Medicare Advantage |
$14,499.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,499.29
|
| Rate for Payer: Mclaren Medicare |
$14,499.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,224.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,674.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,949.22
|
| Rate for Payer: Nomi Health Commercial |
$21,451.41
|
| Rate for Payer: PACE Medicare |
$13,774.33
|
| Rate for Payer: PACE SWMI |
$14,499.29
|
| Rate for Payer: PHP Medicare Advantage |
$14,499.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,809.51
|
| Rate for Payer: Priority Health Medicare |
$14,499.29
|
| Rate for Payer: Priority Health Tiered Network |
$21,447.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14,499.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,105.27
|
| Rate for Payer: UHC Core |
$22,676.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,499.29
|
| Rate for Payer: UHC Exchange |
$18,519.72
|
| Rate for Payer: VA VA |
$14,499.29
|
|
|
VERAPAMIL 0.25 MG/ML IN HEPARINIZED SALINE 2 UNITS/ML
|
Facility
|
IP
|
$175.45
|
|
|
Service Code
|
NDC 09900001092
|
| Hospital Charge Code |
300101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$157.91 |
| Rate for Payer: Aetna American Axle |
$114.04
|
| Rate for Payer: Aetna Commercial |
$149.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.04
|
| Rate for Payer: Cash Price |
$140.36
|
| Rate for Payer: Cofinity Advantage |
$122.81
|
| Rate for Payer: Cofinity Commercial |
$150.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.36
|
| Rate for Payer: Healthscope Commercial |
$157.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.59
|
| Rate for Payer: PHP Commercial |
$149.13
|
| Rate for Payer: Priority Health SBD |
$110.53
|
| Rate for Payer: UMR Bronson Commercial |
$77.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.59
|
|
|
VERAPAMIL 0.25 MG/ML IN HEPARINIZED SALINE 2 UNITS/ML
|
Facility
|
OP
|
$175.45
|
|
|
Service Code
|
NDC 09900001092
|
| Hospital Charge Code |
300101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$157.91 |
| Rate for Payer: Aetna American Axle |
$114.04
|
| Rate for Payer: Aetna Commercial |
$149.13
|
| Rate for Payer: Aetna Medicare |
$87.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.04
|
| Rate for Payer: BCBS Complete |
$70.18
|
| Rate for Payer: Cash Price |
$140.36
|
| Rate for Payer: Cofinity Advantage |
$122.81
|
| Rate for Payer: Cofinity Commercial |
$150.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.36
|
| Rate for Payer: Healthscope Commercial |
$157.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.59
|
| Rate for Payer: PHP Commercial |
$149.13
|
| Rate for Payer: Priority Health SBD |
$110.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.04
|
| Rate for Payer: UHC Core |
$91.41
|
| Rate for Payer: UHC Exchange |
$68.95
|
| Rate for Payer: UMR Bronson Commercial |
$64.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.59
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
NDC 00409114405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.23
|
|
|
Service Code
|
NDC 00409114402
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Aetna American Axle |
$15.10
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.10
|
| Rate for Payer: Cash Price |
$18.58
|
| Rate for Payer: Cofinity Advantage |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$19.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$20.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.42
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health SBD |
$14.63
|
| Rate for Payer: UMR Bronson Commercial |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.42
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.62
|
|
|
Service Code
|
NDC 70756060582
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna American Axle |
$12.10
|
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Medicare |
$9.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.10
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Advantage |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: Priority Health SBD |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC Core |
$9.70
|
| Rate for Payer: UHC Exchange |
$7.32
|
| Rate for Payer: UMR Bronson Commercial |
$6.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.77
|
|
|
Service Code
|
NDC 43066003501
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$11.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Advantage |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.08
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.80
|
| Rate for Payer: UHC Core |
$11.86
|
| Rate for Payer: UHC Exchange |
$8.95
|
| Rate for Payer: UMR Bronson Commercial |
$8.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.96
|
|
|
Service Code
|
NDC 70710164405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.77
|
| Rate for Payer: Cofinity Advantage |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.47
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.47
|
|
