|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.88
|
|
|
Service Code
|
NDC 00143923401
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.19 |
| Max. Negotiated Rate |
$18.79 |
| Rate for Payer: Aetna American Axle |
$13.57
|
| Rate for Payer: Aetna Commercial |
$17.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.57
|
| Rate for Payer: Cash Price |
$16.70
|
| Rate for Payer: Cofinity Commercial |
$14.62
|
| Rate for Payer: Cofinity Commercial |
$17.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.70
|
| Rate for Payer: Healthscope Commercial |
$18.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.75
|
| Rate for Payer: PHP Commercial |
$17.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health SBD |
$13.15
|
| Rate for Payer: UMR Bronson Commercial |
$9.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.66
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16.69
|
|
|
Service Code
|
NDC 55150023501
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$15.02 |
| Rate for Payer: Aetna American Axle |
$10.85
|
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.85
|
| Rate for Payer: Cash Price |
$13.35
|
| Rate for Payer: Cofinity Commercial |
$11.68
|
| Rate for Payer: Cofinity Commercial |
$14.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.35
|
| Rate for Payer: Healthscope Commercial |
$15.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.19
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.85
|
| Rate for Payer: Priority Health SBD |
$10.51
|
| Rate for Payer: UMR Bronson Commercial |
$7.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.52
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.24
|
|
|
Service Code
|
NDC 41616093140
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$20.92 |
| Rate for Payer: Aetna American Axle |
$15.11
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.11
|
| Rate for Payer: Cash Price |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$16.27
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$20.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.11
|
| Rate for Payer: Priority Health SBD |
$14.64
|
| Rate for Payer: UMR Bronson Commercial |
$10.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.43
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.63
|
|
|
Service Code
|
NDC 47335093144
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Aetna American Axle |
$14.71
|
| Rate for Payer: Aetna Commercial |
$19.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.71
|
| Rate for Payer: Cash Price |
$18.10
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$19.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.10
|
| Rate for Payer: Healthscope Commercial |
$20.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.24
|
| Rate for Payer: PHP Commercial |
$19.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.71
|
| Rate for Payer: Priority Health SBD |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$9.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.97
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.57
|
|
|
Service Code
|
NDC 55390003710
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$23.01 |
| Rate for Payer: Aetna American Axle |
$16.62
|
| Rate for Payer: Aetna Commercial |
$21.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.62
|
| Rate for Payer: Cash Price |
$20.46
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$21.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.46
|
| Rate for Payer: Healthscope Commercial |
$23.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.73
|
| Rate for Payer: PHP Commercial |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.62
|
| Rate for Payer: Priority Health SBD |
$16.11
|
| Rate for Payer: UMR Bronson Commercial |
$11.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.18
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.63
|
|
|
Service Code
|
NDC 47335093140
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Aetna American Axle |
$14.71
|
| Rate for Payer: Aetna Commercial |
$19.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.71
|
| Rate for Payer: Cash Price |
$18.10
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$19.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.10
|
| Rate for Payer: Healthscope Commercial |
$20.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.24
|
| Rate for Payer: PHP Commercial |
$19.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.71
|
| Rate for Payer: Priority Health SBD |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$9.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.97
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.08
|
|
|
Service Code
|
NDC 00703291403
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.65 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: Aetna American Axle |
$16.95
|
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: Aetna Medicare |
$13.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.95
|
| Rate for Payer: BCBS Complete |
$10.43
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$23.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.17
|
| Rate for Payer: PHP Commercial |
$22.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.95
|
| Rate for Payer: Priority Health SBD |
$16.43
|
| Rate for Payer: UMR Bronson Commercial |
$9.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.56
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.26
|
|
|
Service Code
|
NDC 00409163221
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$26.33 |
| Rate for Payer: Aetna American Axle |
$19.02
|
| Rate for Payer: Aetna Commercial |
$24.87
|
| Rate for Payer: Aetna Medicare |
$14.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.02
|
| Rate for Payer: BCBS Complete |
$11.70
|
| Rate for Payer: Cash Price |
$23.41
|
| Rate for Payer: Cofinity Commercial |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$25.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$26.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.87
|
| Rate for Payer: PHP Commercial |
$24.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.02
|
| Rate for Payer: Priority Health SBD |
$18.43
|
| Rate for Payer: UMR Bronson Commercial |
$10.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.94
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
IP
|
$23.24
|
|
|
Service Code
|
NDC 41616093140
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$20.92 |
| Rate for Payer: Aetna American Axle |
$15.11
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.11
|
| Rate for Payer: Cash Price |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$16.27
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$20.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.11
|
| Rate for Payer: Priority Health SBD |
$14.64
|
| Rate for Payer: UMR Bronson Commercial |
$10.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.43
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
IP
|
$35.94
|
|
|
Service Code
|
NDC 41616093144
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$32.35 |
| Rate for Payer: Aetna American Axle |
$23.36
|
| Rate for Payer: Aetna Commercial |
$30.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.36
|
| Rate for Payer: Cash Price |
$28.75
|
| Rate for Payer: Cofinity Commercial |
$25.16
|
| Rate for Payer: Cofinity Commercial |
$30.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$32.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: PHP Commercial |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.36
|
| Rate for Payer: Priority Health SBD |
$22.64
|
| Rate for Payer: UMR Bronson Commercial |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.96
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
IP
|
$25.57
|
|
|
Service Code
|
NDC 55390003710
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$23.01 |
| Rate for Payer: Aetna American Axle |
$16.62
|
| Rate for Payer: Aetna Commercial |
$21.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.62
|
| Rate for Payer: Cash Price |
$20.46
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$21.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.46
|
| Rate for Payer: Healthscope Commercial |
$23.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.73
|
| Rate for Payer: PHP Commercial |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.62
|
| Rate for Payer: Priority Health SBD |
$16.11
|
| Rate for Payer: UMR Bronson Commercial |
$11.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.18
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
OP
|
$25.57
|
|
|
Service Code
|
NDC 55390003710
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$23.01 |
| Rate for Payer: Aetna American Axle |
$16.62
|
| Rate for Payer: Aetna Commercial |
$21.73
|
| Rate for Payer: Aetna Medicare |
$12.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.62
|
| Rate for Payer: BCBS Complete |
$10.23
|
| Rate for Payer: Cash Price |
$20.46
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$21.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.46
|
| Rate for Payer: Healthscope Commercial |
$23.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.73
|
| Rate for Payer: PHP Commercial |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.62
|
| Rate for Payer: Priority Health SBD |
$16.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.18
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
OP
|
$23.24
|
|
|
Service Code
|
NDC 41616093140
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$20.92 |
| Rate for Payer: Aetna American Axle |
$15.11
|
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.11
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: Cash Price |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$16.27
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$20.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.75
|
| Rate for Payer: PHP Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.11
|
| Rate for Payer: Priority Health SBD |
$14.64
|
| Rate for Payer: UMR Bronson Commercial |
$8.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.43
|
|
|
VECURONIUM BROMIDE 10 MG IV SOLUTION (CODE)
|
Facility
|
OP
|
$35.94
|
|
|
Service Code
|
NDC 41616093144
|
| Hospital Charge Code |
163723
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$32.35 |
| Rate for Payer: Aetna American Axle |
$23.36
|
| Rate for Payer: Aetna Commercial |
$30.55
|
| Rate for Payer: Aetna Medicare |
$17.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.36
|
| Rate for Payer: BCBS Complete |
$14.38
|
| Rate for Payer: Cash Price |
$28.75
|
| Rate for Payer: Cofinity Commercial |
$25.16
|
| Rate for Payer: Cofinity Commercial |
$30.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$32.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: PHP Commercial |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.36
|
| Rate for Payer: Priority Health SBD |
$22.64
|
| Rate for Payer: UMR Bronson Commercial |
$13.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.96
|
|
|
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
|
$34.17
|
|
|
Service Code
|
NDC 00409163485
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$17.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: BCBS Complete |
$13.67
|
| 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 |
$12.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.81
|
|
|
Service Code
|
NDC 47335093244
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$41.23 |
| Rate for Payer: Aetna American Axle |
$29.78
|
| Rate for Payer: Aetna Commercial |
$38.94
|
| Rate for Payer: Aetna Medicare |
$22.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.78
|
| Rate for Payer: BCBS Complete |
$18.32
|
| 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 |
$16.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.36
|
|
|
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
|
$47.18
|
|
|
Service Code
|
NDC 67457047520
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.76 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Commercial |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.67
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$41.76
|
|
|
Service Code
|
NDC 00143923210
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$37.58 |
| Rate for Payer: Aetna American Axle |
$27.14
|
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna Medicare |
$20.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.14
|
| Rate for Payer: BCBS Complete |
$16.70
|
| Rate for Payer: Cash Price |
$33.41
|
| Rate for Payer: Cofinity Commercial |
$29.23
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.41
|
| Rate for Payer: Healthscope Commercial |
$37.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.14
|
| Rate for Payer: Priority Health SBD |
$26.31
|
| Rate for Payer: UMR Bronson Commercial |
$15.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.32
|
|
|
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
|
$45.81
|
|
|
Service Code
|
NDC 47335093240
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$41.23 |
| Rate for Payer: Aetna American Axle |
$29.78
|
| Rate for Payer: Aetna Commercial |
$38.94
|
| Rate for Payer: Aetna Medicare |
$22.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.78
|
| Rate for Payer: BCBS Complete |
$18.32
|
| 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 |
$16.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.36
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$41.76
|
|
|
Service Code
|
NDC 00143923201
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$37.58 |
| Rate for Payer: Aetna American Axle |
$27.14
|
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.14
|
| Rate for Payer: Cash Price |
$33.41
|
| Rate for Payer: Cofinity Commercial |
$29.23
|
| Rate for Payer: Cofinity Commercial |
$35.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.41
|
| Rate for Payer: Healthscope Commercial |
$37.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.14
|
| Rate for Payer: Priority Health SBD |
$26.31
|
| Rate for Payer: UMR Bronson Commercial |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.32
|
|
|
VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.18
|
|
|
Service Code
|
NDC 67457047500
|
| Hospital Charge Code |
11635
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.76 |
| Max. Negotiated Rate |
$42.46 |
| Rate for Payer: Aetna American Axle |
$30.67
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Commercial |
$33.03
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.67
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
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
|
|
