|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$57.90
|
|
|
Service Code
|
NDC 65219040100
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$52.11 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.22
|
| Rate for Payer: Aetna Medicare |
$28.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: BCBS Complete |
$23.16
|
| Rate for Payer: Cash Price |
$46.32
|
| Rate for Payer: Cofinity Advantage |
$40.53
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.32
|
| Rate for Payer: Healthscope Commercial |
$52.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.42
|
| Rate for Payer: PHP Commercial |
$49.22
|
| Rate for Payer: Priority Health SBD |
$36.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.63
|
| Rate for Payer: UHC Core |
$30.17
|
| Rate for Payer: UHC Exchange |
$22.75
|
| Rate for Payer: UMR Bronson Commercial |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$57.90
|
|
|
Service Code
|
NDC 65219040100
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$52.11 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: Cash Price |
$46.32
|
| Rate for Payer: Cofinity Advantage |
$40.53
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.32
|
| Rate for Payer: Healthscope Commercial |
$52.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.42
|
| Rate for Payer: PHP Commercial |
$49.22
|
| Rate for Payer: Priority Health SBD |
$36.48
|
| Rate for Payer: UMR Bronson Commercial |
$25.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.95
|
|
|
Service Code
|
NDC 70710187601
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.76
|
| Rate for Payer: Cofinity Advantage |
$18.16
|
| Rate for Payer: Cofinity Commercial |
$22.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.46
|
| Rate for Payer: PHP Commercial |
$22.06
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.46
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$57.90
|
|
|
Service Code
|
NDC 65219040101
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$52.11 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.22
|
| Rate for Payer: Aetna Medicare |
$28.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: BCBS Complete |
$23.16
|
| Rate for Payer: Cash Price |
$46.32
|
| Rate for Payer: Cofinity Advantage |
$40.53
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.32
|
| Rate for Payer: Healthscope Commercial |
$52.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.42
|
| Rate for Payer: PHP Commercial |
$49.22
|
| Rate for Payer: Priority Health SBD |
$36.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.63
|
| Rate for Payer: UHC Core |
$30.17
|
| Rate for Payer: UHC Exchange |
$22.75
|
| Rate for Payer: UMR Bronson Commercial |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$57.90
|
|
|
Service Code
|
NDC 65219040101
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$52.11 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: Cash Price |
$46.32
|
| Rate for Payer: Cofinity Advantage |
$40.53
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.32
|
| Rate for Payer: Healthscope Commercial |
$52.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.42
|
| Rate for Payer: PHP Commercial |
$49.22
|
| Rate for Payer: Priority Health SBD |
$36.48
|
| Rate for Payer: UMR Bronson Commercial |
$25.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.10
|
|
|
Service Code
|
NDC 00517610125
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.42 |
| Max. Negotiated Rate |
$66.69 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna Medicare |
$37.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: BCBS Complete |
$29.64
|
| Rate for Payer: Cash Price |
$59.28
|
| Rate for Payer: Cofinity Advantage |
$51.87
|
| Rate for Payer: Cofinity Commercial |
$63.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.28
|
| Rate for Payer: Healthscope Commercial |
$66.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.58
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.16
|
| Rate for Payer: UHC Core |
$38.61
|
| Rate for Payer: UHC Exchange |
$29.12
|
| Rate for Payer: UMR Bronson Commercial |
$27.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.58
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$48.38
|
|
|
Service Code
|
NDC 60505626100
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.29 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna American Axle |
$31.45
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
| Rate for Payer: UMR Bronson Commercial |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.28
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.10
|
|
|
Service Code
|
NDC 00517610101
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.42 |
| Max. Negotiated Rate |
$66.69 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna Medicare |
$37.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: BCBS Complete |
$29.64
|
| Rate for Payer: Cash Price |
$59.28
|
| Rate for Payer: Cofinity Advantage |
$51.87
|
| Rate for Payer: Cofinity Commercial |
$63.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.28
|
| Rate for Payer: Healthscope Commercial |
$66.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.58
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.16
|
| Rate for Payer: UHC Core |
$38.61
|
| Rate for Payer: UHC Exchange |
$29.12
|
| Rate for Payer: UMR Bronson Commercial |
$27.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.58
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$69.38
|
|
|
Service Code
|
NDC 66794025502
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.67 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna American Axle |
$45.10
|
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: Aetna Medicare |
$34.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: BCBS Complete |
$27.75
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Advantage |
$48.57
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: Priority Health SBD |
$43.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.10
|
| Rate for Payer: UHC Core |
$36.15
|
| Rate for Payer: UHC Exchange |
$27.27
|
| Rate for Payer: UMR Bronson Commercial |
$25.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$69.38
|
|
|
Service Code
|
NDC 66794025542
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna American Axle |
$45.10
|
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Advantage |
$48.57
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: Priority Health SBD |
$43.71
|
| Rate for Payer: UMR Bronson Commercial |
$30.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.95
|
|
|
Service Code
|
NDC 70710187601
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.06
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: BCBS Complete |
$10.38
|
| Rate for Payer: Cash Price |
$20.76
|
| Rate for Payer: Cofinity Advantage |
$18.16
|
| Rate for Payer: Cofinity Commercial |
$22.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.46
|
| Rate for Payer: PHP Commercial |
$22.06
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.87
|
| Rate for Payer: UHC Core |
$13.52
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UMR Bronson Commercial |
$9.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.46
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$69.38
|
|
|
Service Code
|
NDC 66794025542
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.67 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna American Axle |
$45.10
|
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: Aetna Medicare |
$34.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: BCBS Complete |
$27.75
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Advantage |
$48.57
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: Priority Health SBD |
$43.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.10
|
| Rate for Payer: UHC Core |
$36.15
|
| Rate for Payer: UHC Exchange |
$27.27
|
| Rate for Payer: UMR Bronson Commercial |
$25.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$48.38
|
|
|
Service Code
|
NDC 60505626105
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna American Axle |
$31.45
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$24.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: BCBS Complete |
$19.35
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.45
|
| Rate for Payer: UHC Core |
$25.21
|
| Rate for Payer: UHC Exchange |
$19.01
|
| Rate for Payer: UMR Bronson Commercial |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.28
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$69.38
|
|
|
Service Code
|
NDC 66794025502
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna American Axle |
$45.10
|
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Advantage |
$48.57
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: Priority Health SBD |
$43.71
|
| Rate for Payer: UMR Bronson Commercial |
$30.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$48.38
|
|
|
Service Code
|
NDC 60505626105
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.29 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna American Axle |
$31.45
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
| Rate for Payer: UMR Bronson Commercial |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.28
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$48.38
|
|
|
Service Code
|
NDC 60505626100
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$43.54 |
| Rate for Payer: Aetna American Axle |
$31.45
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$24.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.45
|
| Rate for Payer: BCBS Complete |
$19.35
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cofinity Advantage |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$41.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.28
|
| Rate for Payer: PHP Commercial |
$41.12
|
| Rate for Payer: Priority Health SBD |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.45
|
| Rate for Payer: UHC Core |
$25.21
|
| Rate for Payer: UHC Exchange |
$19.01
|
| Rate for Payer: UMR Bronson Commercial |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.28
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.10
|
|
|
Service Code
|
NDC 00517610101
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$66.69 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: Cash Price |
$59.28
|
| Rate for Payer: Cofinity Advantage |
$51.87
|
| Rate for Payer: Cofinity Commercial |
$63.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.28
|
| Rate for Payer: Healthscope Commercial |
$66.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.58
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UMR Bronson Commercial |
$32.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.58
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.95
|
|
|
Service Code
|
NDC 70710187607
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.76
|
| Rate for Payer: Cofinity Advantage |
$18.16
|
| Rate for Payer: Cofinity Commercial |
$22.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.46
|
| Rate for Payer: PHP Commercial |
$22.06
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.46
|
|
|
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.10
|
|
|
Service Code
|
NDC 00517610125
|
| Hospital Charge Code |
8878
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$66.69 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: Cash Price |
$59.28
|
| Rate for Payer: Cofinity Advantage |
$51.87
|
| Rate for Payer: Cofinity Commercial |
$63.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.28
|
| Rate for Payer: Healthscope Commercial |
$66.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.58
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UMR Bronson Commercial |
$32.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.58
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
OP
|
$196.90
|
|
|
Service Code
|
NDC 77333098310
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$177.21 |
| Rate for Payer: Aetna American Axle |
$127.98
|
| Rate for Payer: Aetna Commercial |
$167.37
|
| Rate for Payer: Aetna Medicare |
$98.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.98
|
| Rate for Payer: BCBS Complete |
$78.76
|
| Rate for Payer: Cash Price |
$157.52
|
| Rate for Payer: Cofinity Advantage |
$137.83
|
| Rate for Payer: Cofinity Commercial |
$169.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.52
|
| Rate for Payer: Healthscope Commercial |
$177.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.68
|
| Rate for Payer: PHP Commercial |
$167.37
|
| Rate for Payer: Priority Health SBD |
$124.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.98
|
| Rate for Payer: UHC Core |
$102.58
|
| Rate for Payer: UHC Exchange |
$77.38
|
| Rate for Payer: UMR Bronson Commercial |
$72.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.68
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
OP
|
$144.90
|
|
|
Service Code
|
NDC 80681013500
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.61 |
| Max. Negotiated Rate |
$130.41 |
| Rate for Payer: Aetna American Axle |
$94.19
|
| Rate for Payer: Aetna Commercial |
$123.17
|
| Rate for Payer: Aetna Medicare |
$72.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.19
|
| Rate for Payer: BCBS Complete |
$57.96
|
| Rate for Payer: Cash Price |
$115.92
|
| Rate for Payer: Cofinity Advantage |
$101.43
|
| Rate for Payer: Cofinity Commercial |
$124.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.92
|
| Rate for Payer: Healthscope Commercial |
$130.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.67
|
| Rate for Payer: PHP Commercial |
$123.17
|
| Rate for Payer: Priority Health SBD |
$91.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.19
|
| Rate for Payer: UHC Core |
$75.49
|
| Rate for Payer: UHC Exchange |
$56.95
|
| Rate for Payer: UMR Bronson Commercial |
$53.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.67
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
IP
|
$144.90
|
|
|
Service Code
|
NDC 80681013500
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.76 |
| Max. Negotiated Rate |
$130.41 |
| Rate for Payer: Aetna American Axle |
$94.19
|
| Rate for Payer: Aetna Commercial |
$123.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.19
|
| Rate for Payer: Cash Price |
$115.92
|
| Rate for Payer: Cofinity Advantage |
$101.43
|
| Rate for Payer: Cofinity Commercial |
$124.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.92
|
| Rate for Payer: Healthscope Commercial |
$130.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.67
|
| Rate for Payer: PHP Commercial |
$123.17
|
| Rate for Payer: Priority Health SBD |
$91.29
|
| Rate for Payer: UMR Bronson Commercial |
$63.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.67
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
IP
|
$196.90
|
|
|
Service Code
|
NDC 77333098310
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.64 |
| Max. Negotiated Rate |
$177.21 |
| Rate for Payer: Aetna American Axle |
$127.98
|
| Rate for Payer: Aetna Commercial |
$167.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.98
|
| Rate for Payer: Cash Price |
$157.52
|
| Rate for Payer: Cofinity Advantage |
$137.83
|
| Rate for Payer: Cofinity Commercial |
$169.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.52
|
| Rate for Payer: Healthscope Commercial |
$177.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.68
|
| Rate for Payer: PHP Commercial |
$167.37
|
| Rate for Payer: Priority Health SBD |
$124.05
|
| Rate for Payer: UMR Bronson Commercial |
$86.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.68
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
OP
|
$1.97
|
|
|
Service Code
|
NDC 77333098325
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$1.77 |
| Rate for Payer: Aetna American Axle |
$1.28
|
| Rate for Payer: Aetna Commercial |
$1.67
|
| Rate for Payer: Aetna Medicare |
$0.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.28
|
| Rate for Payer: BCBS Complete |
$0.79
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cofinity Advantage |
$1.38
|
| Rate for Payer: Cofinity Commercial |
$1.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.58
|
| Rate for Payer: Healthscope Commercial |
$1.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.48
|
| Rate for Payer: PHP Commercial |
$1.67
|
| Rate for Payer: Priority Health SBD |
$1.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.28
|
| Rate for Payer: UHC Core |
$1.03
|
| Rate for Payer: UHC Exchange |
$0.77
|
| Rate for Payer: UMR Bronson Commercial |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.48
|
|
|
ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE
|
Facility
|
IP
|
$1.97
|
|
|
Service Code
|
NDC 77333098325
|
| Hospital Charge Code |
8880
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$1.77 |
| Rate for Payer: Aetna American Axle |
$1.28
|
| Rate for Payer: Aetna Commercial |
$1.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.28
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cofinity Advantage |
$1.38
|
| Rate for Payer: Cofinity Commercial |
$1.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.58
|
| Rate for Payer: Healthscope Commercial |
$1.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.48
|
| Rate for Payer: PHP Commercial |
$1.67
|
| Rate for Payer: Priority Health SBD |
$1.24
|
| Rate for Payer: UMR Bronson Commercial |
$0.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.48
|
|
