|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$45.81
|
|
|
Service Code
|
NDC 47335093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.16 |
| Max. Negotiated Rate |
$41.23 |
| Rate for Payer: Aetna American Axle |
$29.78
|
| Rate for Payer: Aetna Commercial |
$38.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.78
|
| Rate for Payer: Cash Price |
$36.65
|
| Rate for Payer: Cofinity Commercial |
$32.07
|
| Rate for Payer: Cofinity Commercial |
$39.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.65
|
| Rate for Payer: Healthscope Commercial |
$41.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.94
|
| Rate for Payer: PHP Commercial |
$38.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.78
|
| Rate for Payer: Priority Health SBD |
$28.86
|
| Rate for Payer: UMR Bronson Commercial |
$20.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.36
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.72
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$54.39
|
|
|
Service Code
|
NDC 00409163401
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.93 |
| Max. Negotiated Rate |
$48.95 |
| Rate for Payer: Aetna American Axle |
$35.35
|
| Rate for Payer: Aetna Commercial |
$46.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.35
|
| Rate for Payer: Cash Price |
$43.51
|
| Rate for Payer: Cofinity Commercial |
$38.07
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.51
|
| Rate for Payer: Healthscope Commercial |
$48.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.23
|
| Rate for Payer: PHP Commercial |
$46.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.35
|
| Rate for Payer: Priority Health SBD |
$34.27
|
| Rate for Payer: UMR Bronson Commercial |
$23.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.79
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$51.14
|
|
|
Service Code
|
NDC 55390003910
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna American Axle |
$33.24
|
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna Medicare |
$25.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: BCBS Complete |
$20.46
|
| Rate for Payer: Cash Price |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$35.80
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$46.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.47
|
| Rate for Payer: PHP Commercial |
$43.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.24
|
| Rate for Payer: Priority Health SBD |
$32.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.35
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
NDC 63323078220
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
NDC 63323078220
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$24.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: BCBS Complete |
$19.95
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$18.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.49
|
|
|
Service Code
|
NDC 55150023602
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.32
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$34.17
|
|
|
Service Code
|
NDC 00409163485
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.04
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.21
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.49
|
|
|
Service Code
|
NDC 55150023602
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna Medicare |
$10.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: BCBS Complete |
$8.20
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.32
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.49
|
|
|
Service Code
|
NDC 55150023621
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna Medicare |
$10.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: BCBS Complete |
$8.20
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.32
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.08
|
|
|
Service Code
|
NDC 55150023620
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna American Axle |
$13.05
|
| Rate for Payer: Aetna Commercial |
$17.07
|
| Rate for Payer: Aetna Medicare |
$10.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: BCBS Complete |
$8.03
|
| Rate for Payer: Cash Price |
$16.06
|
| Rate for Payer: Cofinity Commercial |
$14.06
|
| Rate for Payer: Cofinity Commercial |
$17.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.07
|
| Rate for Payer: PHP Commercial |
$17.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.05
|
| Rate for Payer: Priority Health SBD |
$12.65
|
| Rate for Payer: UMR Bronson Commercial |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.06
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.49
|
|
|
Service Code
|
NDC 55150023621
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$18.44 |
| Rate for Payer: Aetna American Axle |
$13.32
|
| Rate for Payer: Aetna Commercial |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.32
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cofinity Commercial |
$14.34
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$18.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.42
|
| Rate for Payer: PHP Commercial |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.32
|
| Rate for Payer: Priority Health SBD |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.37
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.08
|
|
|
Service Code
|
NDC 55150023601
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna American Axle |
$13.05
|
| Rate for Payer: Aetna Commercial |
$17.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: Cash Price |
$16.06
|
| Rate for Payer: Cofinity Commercial |
$14.06
|
| Rate for Payer: Cofinity Commercial |
$17.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.07
|
| Rate for Payer: PHP Commercial |
$17.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.05
|
| Rate for Payer: Priority Health SBD |
$12.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.06
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.08
|
|
|
Service Code
|
NDC 55150023620
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna American Axle |
$13.05
|
| Rate for Payer: Aetna Commercial |
$17.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: Cash Price |
$16.06
|
| Rate for Payer: Cofinity Commercial |
$14.06
|
| Rate for Payer: Cofinity Commercial |
$17.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.07
|
| Rate for Payer: PHP Commercial |
$17.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.05
|
| Rate for Payer: Priority Health SBD |
$12.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.06
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$54.39
|
|
|
Service Code
|
NDC 00409163401
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$48.95 |
| Rate for Payer: Aetna American Axle |
$35.35
|
| Rate for Payer: Aetna Commercial |
$46.23
|
| Rate for Payer: Aetna Medicare |
$27.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.35
|
| Rate for Payer: BCBS Complete |
$21.76
|
| Rate for Payer: Cash Price |
$43.51
|
| Rate for Payer: Cofinity Commercial |
$38.07
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.51
|
| Rate for Payer: Healthscope Commercial |
$48.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.23
|
| Rate for Payer: PHP Commercial |
$46.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.35
|
| Rate for Payer: Priority Health SBD |
$34.27
|
| Rate for Payer: UMR Bronson Commercial |
$20.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.79
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616093240
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.72
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$51.14
|
|
|
Service Code
|
NDC 55390003910
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna American Axle |
$33.24
|
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: Cash Price |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$35.80
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$46.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.47
|
| Rate for Payer: PHP Commercial |
$43.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.24
|
| Rate for Payer: Priority Health SBD |
$32.22
|
| Rate for Payer: UMR Bronson Commercial |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.35
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$51.14
|
|
|
Service Code
|
NDC 55390003910
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$46.03 |
| Rate for Payer: Aetna American Axle |
$33.24
|
| Rate for Payer: Aetna Commercial |
$43.47
|
| Rate for Payer: Aetna Medicare |
$25.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.24
|
| Rate for Payer: BCBS Complete |
$20.46
|
| Rate for Payer: Cash Price |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$35.80
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.91
|
| Rate for Payer: Healthscope Commercial |
$46.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.47
|
| Rate for Payer: PHP Commercial |
$43.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.24
|
| Rate for Payer: Priority Health SBD |
$32.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.35
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna Medicare |
$35.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: BCBS Complete |
$28.75
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.72
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
IP
|
$71.87
|
|
|
Service Code
|
NDC 41616093244
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.72
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VECURONIUM BROMIDE 20 MG IV SOLUTION FOR DRIP
|
Facility
|
OP
|
$71.87
|
|
|
Service Code
|
NDC 41616093240
|
| Hospital Charge Code |
500307
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$64.68 |
| Rate for Payer: Aetna American Axle |
$46.72
|
| Rate for Payer: Aetna Commercial |
$61.09
|
| Rate for Payer: Aetna Medicare |
$35.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.72
|
| Rate for Payer: BCBS Complete |
$28.75
|
| Rate for Payer: Cash Price |
$57.50
|
| Rate for Payer: Cofinity Commercial |
$50.31
|
| Rate for Payer: Cofinity Commercial |
$61.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$64.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$61.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.72
|
| Rate for Payer: Priority Health SBD |
$45.28
|
| Rate for Payer: UMR Bronson Commercial |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.90
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24,335.77
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$21,902.19 |
| Rate for Payer: Aetna American Axle |
$15,818.25
|
| Rate for Payer: Aetna Commercial |
$20,685.40
|
| Rate for Payer: Aetna Medicare |
$22.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,818.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.64
|
| Rate for Payer: BCBS Complete |
$11.99
|
| Rate for Payer: BCBS MAPPO |
$21.31
|
| Rate for Payer: BCN Medicare Advantage |
$21.31
|
| Rate for Payer: Cash Price |
$19,468.62
|
| Rate for Payer: Cash Price |
$19,468.62
|
| Rate for Payer: Cofinity Commercial |
$20,928.76
|
| Rate for Payer: Cofinity Commercial |
$17,035.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$17,035.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,468.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$21,902.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,035.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,251.83
|
| Rate for Payer: Mclaren Medicaid |
$11.42
|
| Rate for Payer: Mclaren Medicare |
$21.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.38
|
| Rate for Payer: Meridian Medicaid |
$11.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,685.40
|
| Rate for Payer: PACE Medicare |
$20.24
|
| Rate for Payer: PACE SWMI |
$21.31
|
| Rate for Payer: PHP Commercial |
$20,685.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,818.25
|
| Rate for Payer: Priority Health Medicare |
$21.31
|
| Rate for Payer: Priority Health SBD |
$15,331.54
|
| Rate for Payer: Railroad Medicare Medicare |
$21.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.31
|
| Rate for Payer: UHC Exchange |
$40.73
|
| Rate for Payer: UHC Medicare Advantage |
$21.31
|
| Rate for Payer: UHCCP Medicaid |
$11.42
|
| Rate for Payer: UMR Bronson Commercial |
$9,004.23
|
| Rate for Payer: VA VA |
$21.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,251.83
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24,335.77
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10,707.74 |
| Max. Negotiated Rate |
$21,902.19 |
| Rate for Payer: Aetna American Axle |
$15,818.25
|
| Rate for Payer: Aetna Commercial |
$20,685.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,818.25
|
| Rate for Payer: Cash Price |
$19,468.62
|
| Rate for Payer: Cofinity Commercial |
$17,035.04
|
| Rate for Payer: Cofinity Commercial |
$20,928.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$17,035.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,468.62
|
| Rate for Payer: Healthscope Commercial |
$21,902.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,035.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,251.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,685.40
|
| Rate for Payer: PHP Commercial |
$20,685.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15,818.25
|
| Rate for Payer: Priority Health SBD |
$15,331.54
|
| Rate for Payer: UMR Bronson Commercial |
$10,707.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,251.83
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
OP
|
$13,484.79
|
|
|
Service Code
|
NDC 00074057630
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,989.37 |
| Max. Negotiated Rate |
$12,136.31 |
| Rate for Payer: Aetna American Axle |
$8,765.11
|
| Rate for Payer: Aetna Commercial |
$11,462.07
|
| Rate for Payer: Aetna Medicare |
$6,742.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,765.11
|
| Rate for Payer: BCBS Complete |
$5,393.92
|
| Rate for Payer: Cash Price |
$10,787.83
|
| Rate for Payer: Cofinity Commercial |
$11,596.92
|
| Rate for Payer: Cofinity Commercial |
$9,439.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,439.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,787.83
|
| Rate for Payer: Healthscope Commercial |
$12,136.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,439.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,113.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,462.07
|
| Rate for Payer: PHP Commercial |
$11,462.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,765.11
|
| Rate for Payer: Priority Health SBD |
$8,495.42
|
| Rate for Payer: UMR Bronson Commercial |
$4,989.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,113.59
|
|
|
VENETOCLAX 100 MG TABLET
|
Facility
|
OP
|
$481.56
|
|
|
Service Code
|
NDC 00074057611
|
| Hospital Charge Code |
178563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.18 |
| Max. Negotiated Rate |
$433.40 |
| Rate for Payer: Aetna American Axle |
$313.01
|
| Rate for Payer: Aetna Commercial |
$409.33
|
| Rate for Payer: Aetna Medicare |
$240.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.01
|
| Rate for Payer: BCBS Complete |
$192.62
|
| Rate for Payer: Cash Price |
$385.25
|
| Rate for Payer: Cofinity Commercial |
$337.09
|
| Rate for Payer: Cofinity Commercial |
$414.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.25
|
| Rate for Payer: Healthscope Commercial |
$433.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.33
|
| Rate for Payer: PHP Commercial |
$409.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.01
|
| Rate for Payer: Priority Health SBD |
$303.38
|
| Rate for Payer: UMR Bronson Commercial |
$178.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.17
|
|
