|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.68
|
|
|
Service Code
|
NDC 70121158601
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna American Axle |
$14.74
|
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.74
|
| Rate for Payer: Cash Price |
$18.14
|
| Rate for Payer: Cofinity Advantage |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.01
|
| Rate for Payer: PHP Commercial |
$19.28
|
| Rate for Payer: Priority Health SBD |
$14.29
|
| Rate for Payer: UMR Bronson Commercial |
$9.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.01
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.23
|
|
|
Service Code
|
NDC 00409114462
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Aetna American Axle |
$15.10
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.10
|
| Rate for Payer: BCBS Complete |
$9.29
|
| 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: MI Amish Medical Board Commercial |
$18.58
|
| 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: UHC All Payor (Choice/PPO) |
$15.10
|
| Rate for Payer: UHC Core |
$12.10
|
| Rate for Payer: UHC Exchange |
$9.13
|
| Rate for Payer: UMR Bronson Commercial |
$8.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.42
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$281.01
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$103.97 |
| Max. Negotiated Rate |
$252.91 |
| Rate for Payer: Aetna American Axle |
$182.66
|
| Rate for Payer: Aetna Commercial |
$238.86
|
| Rate for Payer: Aetna Medicare |
$140.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.66
|
| Rate for Payer: BCBS Complete |
$112.40
|
| Rate for Payer: Cash Price |
$224.81
|
| Rate for Payer: Cofinity Advantage |
$196.71
|
| Rate for Payer: Cofinity Commercial |
$241.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.81
|
| Rate for Payer: Healthscope Commercial |
$252.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.76
|
| Rate for Payer: PHP Commercial |
$238.86
|
| Rate for Payer: Priority Health SBD |
$177.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.66
|
| Rate for Payer: UHC Core |
$146.41
|
| Rate for Payer: UHC Exchange |
$110.44
|
| Rate for Payer: UMR Bronson Commercial |
$103.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.76
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.79
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.83 |
| Max. Negotiated Rate |
$16.01 |
| Rate for Payer: Aetna American Axle |
$11.56
|
| Rate for Payer: Aetna Commercial |
$15.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.56
|
| Rate for Payer: Cash Price |
$14.23
|
| Rate for Payer: Cofinity Advantage |
$12.45
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.23
|
| Rate for Payer: Healthscope Commercial |
$16.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.34
|
| Rate for Payer: PHP Commercial |
$15.12
|
| Rate for Payer: Priority Health SBD |
$11.21
|
| Rate for Payer: UMR Bronson Commercial |
$7.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.34
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.79
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$16.01 |
| Rate for Payer: Aetna American Axle |
$11.56
|
| Rate for Payer: Aetna Commercial |
$15.12
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.56
|
| Rate for Payer: BCBS Complete |
$7.12
|
| Rate for Payer: Cash Price |
$14.23
|
| Rate for Payer: Cofinity Advantage |
$12.45
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.23
|
| Rate for Payer: Healthscope Commercial |
$16.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.34
|
| Rate for Payer: PHP Commercial |
$15.12
|
| Rate for Payer: Priority Health SBD |
$11.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.56
|
| Rate for Payer: UHC Core |
$9.27
|
| Rate for Payer: UHC Exchange |
$6.99
|
| Rate for Payer: UMR Bronson Commercial |
$6.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.34
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.64
|
|
|
Service Code
|
NDC 70069027205
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Advantage |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.73
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$8.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.62
|
|
|
Service Code
|
NDC 55150034301
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$24.86 |
| Rate for Payer: Aetna American Axle |
$17.95
|
| Rate for Payer: Aetna Commercial |
$23.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.95
|
| Rate for Payer: Cash Price |
$22.10
|
| Rate for Payer: Cofinity Advantage |
$19.33
|
| Rate for Payer: Cofinity Commercial |
$23.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.10
|
| Rate for Payer: Healthscope Commercial |
$24.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.71
|
| Rate for Payer: PHP Commercial |
$23.48
|
| Rate for Payer: Priority Health SBD |
$17.40
|
| Rate for Payer: UMR Bronson Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.71
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.68
|
|
|
Service Code
|
NDC 70121158603
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna American Axle |
$14.74
|
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna Medicare |
$11.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.74
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: Cash Price |
$18.14
|
| Rate for Payer: Cofinity Advantage |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.01
|
| Rate for Payer: PHP Commercial |
$19.28
|
| Rate for Payer: Priority Health SBD |
$14.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.74
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Exchange |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$8.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.01
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.77
|
|
|
Service Code
|
NDC 43066003501
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| 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: 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: UMR Bronson Commercial |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.96
|
|
|
Service Code
|
NDC 70710164405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: BCBS Complete |
$10.38
|
| 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: MI Amish Medical Board Commercial |
$20.77
|
| 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: UHC All Payor (Choice/PPO) |
$16.87
|
| Rate for Payer: UHC Core |
$13.53
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.47
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
NDC 00409114405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$13.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: BCBS Complete |
$10.73
|
| 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: MI Amish Medical Board Commercial |
$21.46
|
| 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: UHC All Payor (Choice/PPO) |
$17.44
|
| Rate for Payer: UHC Core |
$13.98
|
| Rate for Payer: UHC Exchange |
$10.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.68
|
|
|
Service Code
|
NDC 70121158603
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$20.41 |
| Rate for Payer: Aetna American Axle |
$14.74
|
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.74
|
| Rate for Payer: Cash Price |
$18.14
|
| Rate for Payer: Cofinity Advantage |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.01
|
| Rate for Payer: PHP Commercial |
$19.28
|
| Rate for Payer: Priority Health SBD |
$14.29
|
| Rate for Payer: UMR Bronson Commercial |
$9.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.01
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.62
|
|
|
Service Code
|
NDC 55150034305
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$24.86 |
| Rate for Payer: Aetna American Axle |
$17.95
|
| Rate for Payer: Aetna Commercial |
$23.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.95
|
| Rate for Payer: Cash Price |
$22.10
|
| Rate for Payer: Cofinity Advantage |
$19.33
|
| Rate for Payer: Cofinity Commercial |
$23.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.10
|
| Rate for Payer: Healthscope Commercial |
$24.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.71
|
| Rate for Payer: PHP Commercial |
$23.48
|
| Rate for Payer: Priority Health SBD |
$17.40
|
| Rate for Payer: UMR Bronson Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.71
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.69
|
|
|
Service Code
|
NDC 51754020301
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$19.52 |
| Rate for Payer: Aetna American Axle |
$14.10
|
| Rate for Payer: Aetna Commercial |
$18.44
|
| Rate for Payer: Aetna Medicare |
$10.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.10
|
| Rate for Payer: BCBS Complete |
$8.68
|
| Rate for Payer: Cash Price |
$17.35
|
| Rate for Payer: Cofinity Advantage |
$15.18
|
| Rate for Payer: Cofinity Commercial |
$18.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.35
|
| Rate for Payer: Healthscope Commercial |
$19.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.27
|
| Rate for Payer: PHP Commercial |
$18.44
|
| Rate for Payer: Priority Health SBD |
$13.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.10
|
| Rate for Payer: UHC Core |
$11.30
|
| Rate for Payer: UHC Exchange |
$8.52
|
| Rate for Payer: UMR Bronson Commercial |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.27
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.77
|
|
|
Service Code
|
NDC 43066003505
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| 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: 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: UMR Bronson Commercial |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.23
|
|
|
Service Code
|
NDC 00409114462
|
| 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
|
IP
|
$32.47
|
|
|
Service Code
|
NDC 72485010905
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna American Axle |
$21.11
|
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Advantage |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.35
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.29
|
|
|
Service Code
|
NDC 70756060685
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$19.16 |
| Rate for Payer: Aetna American Axle |
$13.84
|
| Rate for Payer: Aetna Commercial |
$18.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.84
|
| Rate for Payer: Cash Price |
$17.03
|
| Rate for Payer: Cofinity Advantage |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$18.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$19.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.97
|
| Rate for Payer: PHP Commercial |
$18.10
|
| Rate for Payer: Priority Health SBD |
$13.41
|
| Rate for Payer: UMR Bronson Commercial |
$9.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.97
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$167.97 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Advantage |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.31
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UMR Bronson Commercial |
$167.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.31
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$141.24 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna Medicare |
$190.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: BCBS Complete |
$152.70
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Advantage |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.31
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.13
|
| Rate for Payer: UHC Core |
$198.89
|
| Rate for Payer: UHC Exchange |
$150.02
|
| Rate for Payer: UMR Bronson Commercial |
$141.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.31
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$338.40
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.21 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna American Axle |
$219.96
|
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna Medicare |
$169.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: BCBS Complete |
$135.36
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Advantage |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.96
|
| Rate for Payer: UHC Core |
$176.31
|
| Rate for Payer: UHC Exchange |
$132.99
|
| Rate for Payer: UMR Bronson Commercial |
$125.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna American Axle |
$218.43
|
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna Medicare |
$168.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.43
|
| Rate for Payer: BCBS Complete |
$134.42
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Advantage |
$235.24
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health SBD |
$211.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.43
|
| Rate for Payer: UHC Core |
$175.08
|
| Rate for Payer: UHC Exchange |
$132.07
|
| Rate for Payer: UMR Bronson Commercial |
$124.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$336.05
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.86 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna American Axle |
$218.43
|
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.43
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Advantage |
$235.24
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health SBD |
$211.71
|
| Rate for Payer: UMR Bronson Commercial |
$147.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.90 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna American Axle |
$219.96
|
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Advantage |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.80
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UMR Bronson Commercial |
$148.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
IP
|
$1,461.13
|
|
|
Service Code
|
NDC 52536048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$642.90 |
| Max. Negotiated Rate |
$1,315.02 |
| Rate for Payer: Aetna American Axle |
$949.73
|
| Rate for Payer: Aetna Commercial |
$1,241.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.73
|
| Rate for Payer: Cash Price |
$1,168.90
|
| Rate for Payer: Cofinity Advantage |
$1,022.79
|
| Rate for Payer: Cofinity Commercial |
$1,256.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,168.90
|
| Rate for Payer: Healthscope Commercial |
$1,315.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,022.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,095.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.85
|
| Rate for Payer: PHP Commercial |
$1,241.96
|
| Rate for Payer: Priority Health SBD |
$920.51
|
| Rate for Payer: UMR Bronson Commercial |
$642.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,095.85
|
|
