|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
OP
|
$1,678.32
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$620.98 |
| Max. Negotiated Rate |
$1,510.49 |
| Rate for Payer: Aetna American Axle |
$1,090.91
|
| Rate for Payer: Aetna Commercial |
$1,426.57
|
| Rate for Payer: Aetna Medicare |
$839.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.91
|
| Rate for Payer: BCBS Complete |
$671.33
|
| Rate for Payer: Cash Price |
$1,342.66
|
| Rate for Payer: Cofinity Advantage |
$1,174.82
|
| Rate for Payer: Cofinity Commercial |
$1,443.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.66
|
| Rate for Payer: Healthscope Commercial |
$1,510.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,174.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,342.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.74
|
| Rate for Payer: PHP Commercial |
$1,426.57
|
| Rate for Payer: Priority Health SBD |
$1,057.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.91
|
| Rate for Payer: UHC Core |
$874.40
|
| Rate for Payer: UHC Exchange |
$659.58
|
| Rate for Payer: UMR Bronson Commercial |
$620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.74
|
|
|
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
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
IP
|
$1,678.32
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$738.46 |
| Max. Negotiated Rate |
$1,510.49 |
| Rate for Payer: Aetna American Axle |
$1,090.91
|
| Rate for Payer: Aetna Commercial |
$1,426.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.91
|
| Rate for Payer: Cash Price |
$1,342.66
|
| Rate for Payer: Cofinity Advantage |
$1,174.82
|
| Rate for Payer: Cofinity Commercial |
$1,443.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.66
|
| Rate for Payer: Healthscope Commercial |
$1,510.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,174.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.74
|
| Rate for Payer: PHP Commercial |
$1,426.57
|
| Rate for Payer: Priority Health SBD |
$1,057.34
|
| Rate for Payer: UMR Bronson Commercial |
$738.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.74
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$194.12 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna American Axle |
$341.02
|
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna Medicare |
$262.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: BCBS Complete |
$209.86
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Advantage |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$419.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.48
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health SBD |
$330.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.02
|
| Rate for Payer: UHC Core |
$273.34
|
| Rate for Payer: UHC Exchange |
$206.18
|
| Rate for Payer: UMR Bronson Commercial |
$194.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$205.20
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.29 |
| Max. Negotiated Rate |
$184.68 |
| Rate for Payer: Aetna American Axle |
$133.38
|
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.38
|
| Rate for Payer: Cash Price |
$164.16
|
| Rate for Payer: Cofinity Advantage |
$143.64
|
| Rate for Payer: Cofinity Commercial |
$176.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.16
|
| Rate for Payer: Healthscope Commercial |
$184.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.90
|
| Rate for Payer: PHP Commercial |
$174.42
|
| Rate for Payer: Priority Health SBD |
$129.28
|
| Rate for Payer: UMR Bronson Commercial |
$90.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.90
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$325.92
|
|
|
Service Code
|
NDC 57664011688
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.40 |
| Max. Negotiated Rate |
$293.33 |
| Rate for Payer: Aetna American Axle |
$211.85
|
| Rate for Payer: Aetna Commercial |
$277.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cofinity Advantage |
$228.14
|
| Rate for Payer: Cofinity Commercial |
$280.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.74
|
| Rate for Payer: Healthscope Commercial |
$293.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.44
|
| Rate for Payer: PHP Commercial |
$277.03
|
| Rate for Payer: Priority Health SBD |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$143.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.44
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$325.92
|
|
|
Service Code
|
NDC 57664011688
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.59 |
| Max. Negotiated Rate |
$293.33 |
| Rate for Payer: Aetna American Axle |
$211.85
|
| Rate for Payer: Aetna Commercial |
$277.03
|
| Rate for Payer: Aetna Medicare |
$162.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$130.37
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cofinity Advantage |
$228.14
|
| Rate for Payer: Cofinity Commercial |
$280.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.74
|
| Rate for Payer: Healthscope Commercial |
$293.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.44
|
| Rate for Payer: PHP Commercial |
$277.03
|
| Rate for Payer: Priority Health SBD |
$205.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.85
|
| Rate for Payer: UHC Core |
$169.80
|
| Rate for Payer: UHC Exchange |
$128.09
|
| Rate for Payer: UMR Bronson Commercial |
$120.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.44
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Advantage |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.94
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Advantage |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.94
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.41
|
| Rate for Payer: UHC Core |
$2.74
|
| Rate for Payer: UHC Exchange |
$2.06
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$268.80
|
|
|
Service Code
|
NDC 75834032001
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.27 |
| Max. Negotiated Rate |
$241.92 |
| Rate for Payer: Aetna American Axle |
$174.72
|
| Rate for Payer: Aetna Commercial |
$228.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.72
|
| Rate for Payer: Cash Price |
$215.04
|
| Rate for Payer: Cofinity Advantage |
$188.16
|
| Rate for Payer: Cofinity Commercial |
$231.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.04
|
| Rate for Payer: Healthscope Commercial |
$241.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.60
|
| Rate for Payer: PHP Commercial |
$228.48
|
| Rate for Payer: Priority Health SBD |
$169.34
|
| Rate for Payer: UMR Bronson Commercial |
$118.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.60
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$268.80
|
|
|
Service Code
|
NDC 75834032001
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.46 |
| Max. Negotiated Rate |
$241.92 |
| Rate for Payer: Aetna American Axle |
$174.72
|
| Rate for Payer: Aetna Commercial |
$228.48
|
| Rate for Payer: Aetna Medicare |
$134.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.72
|
| Rate for Payer: BCBS Complete |
$107.52
|
| Rate for Payer: Cash Price |
$215.04
|
| Rate for Payer: Cofinity Advantage |
$188.16
|
| Rate for Payer: Cofinity Commercial |
$231.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.04
|
| Rate for Payer: Healthscope Commercial |
$241.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.60
|
| Rate for Payer: PHP Commercial |
$228.48
|
| Rate for Payer: Priority Health SBD |
$169.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.72
|
| Rate for Payer: UHC Core |
$140.04
|
| Rate for Payer: UHC Exchange |
$105.64
|
| Rate for Payer: UMR Bronson Commercial |
$99.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.60
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$205.20
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.92 |
| Max. Negotiated Rate |
$184.68 |
| Rate for Payer: Aetna American Axle |
$133.38
|
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna Medicare |
$102.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.38
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: Cash Price |
$164.16
|
| Rate for Payer: Cofinity Advantage |
$143.64
|
| Rate for Payer: Cofinity Commercial |
$176.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.16
|
| Rate for Payer: Healthscope Commercial |
$184.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.90
|
| Rate for Payer: PHP Commercial |
$174.42
|
| Rate for Payer: Priority Health SBD |
$129.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.38
|
| Rate for Payer: UHC Core |
$106.91
|
| Rate for Payer: UHC Exchange |
$80.64
|
| Rate for Payer: UMR Bronson Commercial |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.90
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$230.84 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna American Axle |
$341.02
|
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Advantage |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.48
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health SBD |
$330.52
|
| Rate for Payer: UMR Bronson Commercial |
$230.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$439.45
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna Medicare |
$219.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: BCBS Complete |
$175.78
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Advantage |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.64
|
| Rate for Payer: UHC Core |
$228.95
|
| Rate for Payer: UHC Exchange |
$172.70
|
| Rate for Payer: UMR Bronson Commercial |
$162.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$439.45
|
|
|
Service Code
|
NDC 68462029301
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Advantage |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UMR Bronson Commercial |
$193.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$786.72
|
|
|
Service Code
|
NDC 60687051501
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$346.16 |
| Max. Negotiated Rate |
$708.05 |
| Rate for Payer: Aetna American Axle |
$511.37
|
| Rate for Payer: Aetna Commercial |
$668.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.37
|
| Rate for Payer: Cash Price |
$629.38
|
| Rate for Payer: Cofinity Advantage |
$550.70
|
| Rate for Payer: Cofinity Commercial |
$676.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.38
|
| Rate for Payer: Healthscope Commercial |
$708.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$590.04
|
| Rate for Payer: PHP Commercial |
$668.71
|
| Rate for Payer: Priority Health SBD |
$495.63
|
| Rate for Payer: UMR Bronson Commercial |
$346.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.04
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$205.20
|
|
|
Service Code
|
NDC 75834015901
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.29 |
| Max. Negotiated Rate |
$184.68 |
| Rate for Payer: Aetna American Axle |
$133.38
|
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.38
|
| Rate for Payer: Cash Price |
$164.16
|
| Rate for Payer: Cofinity Advantage |
$143.64
|
| Rate for Payer: Cofinity Commercial |
$176.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.16
|
| Rate for Payer: Healthscope Commercial |
$184.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.90
|
| Rate for Payer: PHP Commercial |
$174.42
|
| Rate for Payer: Priority Health SBD |
$129.28
|
| Rate for Payer: UMR Bronson Commercial |
$90.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.90
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$205.20
|
|
|
Service Code
|
NDC 75834015901
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.92 |
| Max. Negotiated Rate |
$184.68 |
| Rate for Payer: Aetna American Axle |
$133.38
|
| Rate for Payer: Aetna Commercial |
$174.42
|
| Rate for Payer: Aetna Medicare |
$102.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.38
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: Cash Price |
$164.16
|
| Rate for Payer: Cofinity Advantage |
$143.64
|
| Rate for Payer: Cofinity Commercial |
$176.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.16
|
| Rate for Payer: Healthscope Commercial |
$184.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.90
|
| Rate for Payer: PHP Commercial |
$174.42
|
| Rate for Payer: Priority Health SBD |
$129.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.38
|
| Rate for Payer: UHC Core |
$106.91
|
| Rate for Payer: UHC Exchange |
$80.64
|
| Rate for Payer: UMR Bronson Commercial |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.90
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$786.72
|
|
|
Service Code
|
NDC 60687051501
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.09 |
| Max. Negotiated Rate |
$708.05 |
| Rate for Payer: Aetna American Axle |
$511.37
|
| Rate for Payer: Aetna Commercial |
$668.71
|
| Rate for Payer: Aetna Medicare |
$393.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.37
|
| Rate for Payer: BCBS Complete |
$314.69
|
| Rate for Payer: Cash Price |
$629.38
|
| Rate for Payer: Cofinity Advantage |
$550.70
|
| Rate for Payer: Cofinity Commercial |
$676.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.38
|
| Rate for Payer: Healthscope Commercial |
$708.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$629.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$590.04
|
| Rate for Payer: PHP Commercial |
$668.71
|
| Rate for Payer: Priority Health SBD |
$495.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$511.37
|
| Rate for Payer: UHC Core |
$409.88
|
| Rate for Payer: UHC Exchange |
$309.18
|
| Rate for Payer: UMR Bronson Commercial |
$291.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.04
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$305.50
|
|
|
Service Code
|
NDC 68462026001
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.03 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.57
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna Medicare |
$152.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.57
|
| Rate for Payer: BCBS Complete |
$122.20
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Advantage |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.12
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health SBD |
$192.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.57
|
| Rate for Payer: UHC Core |
$159.17
|
| Rate for Payer: UHC Exchange |
$120.06
|
| Rate for Payer: UMR Bronson Commercial |
$113.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$7.87
|
|
|
Service Code
|
NDC 60687051511
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Aetna American Axle |
$5.12
|
| Rate for Payer: Aetna Commercial |
$6.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.12
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cofinity Advantage |
$5.51
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.30
|
| Rate for Payer: Healthscope Commercial |
$7.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.90
|
| Rate for Payer: PHP Commercial |
$6.69
|
| Rate for Payer: Priority Health SBD |
$4.96
|
| Rate for Payer: UMR Bronson Commercial |
$3.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$7.87
|
|
|
Service Code
|
NDC 60687051511
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Aetna American Axle |
$5.12
|
| Rate for Payer: Aetna Commercial |
$6.69
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.12
|
| Rate for Payer: BCBS Complete |
$3.15
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cofinity Advantage |
$5.51
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.30
|
| Rate for Payer: Healthscope Commercial |
$7.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.90
|
| Rate for Payer: PHP Commercial |
$6.69
|
| Rate for Payer: Priority Health SBD |
$4.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Core |
$4.10
|
| Rate for Payer: UHC Exchange |
$3.09
|
| Rate for Payer: UMR Bronson Commercial |
$2.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
|
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$305.50
|
|
|
Service Code
|
NDC 68462026001
|
| Hospital Charge Code |
8531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.42 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.57
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.57
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Advantage |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.12
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health SBD |
$192.47
|
| Rate for Payer: UMR Bronson Commercial |
$134.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$9,124.06
|
|
|
Service Code
|
APR-DRG 3101
|
| Min. Negotiated Rate |
$8,689.58 |
| Max. Negotiated Rate |
$9,124.06 |
| Rate for Payer: BCBS Complete |
$9,124.06
|
| Rate for Payer: Mclaren Medicaid |
$8,689.58
|
| Rate for Payer: Meridian Medicaid |
$9,124.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,689.58
|
| Rate for Payer: UHC Medicaid |
$8,689.58
|
| Rate for Payer: UHCCP Medicaid |
$8,689.58
|
|
|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$29,767.46
|
|
|
Service Code
|
APR-DRG 3104
|
| Min. Negotiated Rate |
$28,349.96 |
| Max. Negotiated Rate |
$29,767.46 |
| Rate for Payer: BCBS Complete |
$29,767.46
|
| Rate for Payer: Mclaren Medicaid |
$28,349.96
|
| Rate for Payer: Meridian Medicaid |
$29,767.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,349.96
|
| Rate for Payer: UHC Medicaid |
$28,349.96
|
| Rate for Payer: UHCCP Medicaid |
$28,349.96
|
|
