|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$296.40
|
|
|
Service Code
|
NDC 00904646961
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.67 |
| Max. Negotiated Rate |
$266.76 |
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Aetna American Axle |
$192.66
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna Medicare |
$148.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: BCBS Complete |
$118.56
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: UMR Bronson Commercial |
$109.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.30
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$4.64
|
|
|
Service Code
|
NDC 68084070911
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Aetna American Axle |
$3.02
|
| Rate for Payer: Aetna Commercial |
$3.94
|
| Rate for Payer: Aetna Medicare |
$2.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: BCBS Complete |
$1.86
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Cofinity Commercial |
$3.25
|
| Rate for Payer: Cofinity Commercial |
$3.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.94
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.02
|
| Rate for Payer: Priority Health SBD |
$2.92
|
| Rate for Payer: UMR Bronson Commercial |
$1.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.48
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$463.60
|
|
|
Service Code
|
NDC 68084070901
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$203.98 |
| Max. Negotiated Rate |
$417.24 |
| Rate for Payer: Aetna American Axle |
$301.34
|
| Rate for Payer: Aetna Commercial |
$394.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.34
|
| Rate for Payer: Cash Price |
$370.88
|
| Rate for Payer: Cofinity Commercial |
$324.52
|
| Rate for Payer: Cofinity Commercial |
$398.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.88
|
| Rate for Payer: Healthscope Commercial |
$417.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.06
|
| Rate for Payer: PHP Commercial |
$394.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.34
|
| Rate for Payer: Priority Health SBD |
$292.07
|
| Rate for Payer: UMR Bronson Commercial |
$203.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.70
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$226.58
|
|
|
Service Code
|
NDC 00093738598
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.83 |
| Max. Negotiated Rate |
$203.92 |
| Rate for Payer: Aetna American Axle |
$147.28
|
| Rate for Payer: Aetna Commercial |
$192.59
|
| Rate for Payer: Aetna Medicare |
$113.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.28
|
| Rate for Payer: BCBS Complete |
$90.63
|
| Rate for Payer: Cash Price |
$181.26
|
| Rate for Payer: Cofinity Commercial |
$158.61
|
| Rate for Payer: Cofinity Commercial |
$194.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$158.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.26
|
| Rate for Payer: Healthscope Commercial |
$203.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.59
|
| Rate for Payer: PHP Commercial |
$192.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.28
|
| Rate for Payer: Priority Health SBD |
$142.75
|
| Rate for Payer: UMR Bronson Commercial |
$83.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.94
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4.64
|
|
|
Service Code
|
NDC 68084070911
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: Aetna American Axle |
$3.02
|
| Rate for Payer: Aetna Commercial |
$3.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Cofinity Commercial |
$3.25
|
| Rate for Payer: Cofinity Commercial |
$3.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.02
|
| Rate for Payer: Priority Health SBD |
$2.92
|
| Rate for Payer: UMR Bronson Commercial |
$2.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.48
|
|
|
VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$296.40
|
|
|
Service Code
|
NDC 00904646961
|
| Hospital Charge Code |
27858
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.42 |
| Max. Negotiated Rate |
$266.76 |
| Rate for Payer: Aetna American Axle |
$192.66
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: UMR Bronson Commercial |
$130.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.30
|
|
|
VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,950.41
|
|
|
Service Code
|
CPT 36500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.97 |
| Max. Negotiated Rate |
$1,950.41 |
| Rate for Payer: BCBS Trust/PPO |
$1,950.41
|
| Rate for Payer: BCN Commercial |
$1,950.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.47
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$174.97
|
|
|
VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 69424
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,190.99
|
| Rate for Payer: BCN Commercial |
$3,190.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$9,532.50
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.38 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UMR Bronson Commercial |
$29.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.08
|
|
|
VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$66.78
|
|
|
Service Code
|
NDC 00173068224
|
| Hospital Charge Code |
32309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$60.10 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.76
|
| Rate for Payer: Aetna Medicare |
$33.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: BCBS Complete |
$26.71
|
| Rate for Payer: Cash Price |
$53.42
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.42
|
| Rate for Payer: Healthscope Commercial |
$60.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.76
|
| Rate for Payer: PHP Commercial |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health SBD |
$42.07
|
| Rate for Payer: UMR Bronson Commercial |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.08
|
|
|
VERAPAMIL 0.25 MG/ML IN HEPARINIZED SALINE 2 UNITS/ML
|
Facility
|
IP
|
$175.45
|
|
|
Service Code
|
NDC 09900001092
|
| Hospital Charge Code |
300101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$157.90 |
| Rate for Payer: Aetna American Axle |
$114.04
|
| Rate for Payer: Aetna Commercial |
$149.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.04
|
| Rate for Payer: Cash Price |
$140.36
|
| Rate for Payer: Cofinity Commercial |
$122.82
|
| Rate for Payer: Cofinity Commercial |
$150.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.36
|
| Rate for Payer: Healthscope Commercial |
$157.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.13
|
| Rate for Payer: PHP Commercial |
$149.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.04
|
| Rate for Payer: Priority Health SBD |
$110.53
|
| Rate for Payer: UMR Bronson Commercial |
$77.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.59
|
|
|
VERAPAMIL 0.25 MG/ML IN HEPARINIZED SALINE 2 UNITS/ML
|
Facility
|
OP
|
$175.45
|
|
|
Service Code
|
NDC 09900001092
|
| Hospital Charge Code |
300101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$157.90 |
| Rate for Payer: Aetna American Axle |
$114.04
|
| Rate for Payer: Aetna Commercial |
$149.13
|
| Rate for Payer: Aetna Medicare |
$87.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.04
|
| Rate for Payer: BCBS Complete |
$70.18
|
| Rate for Payer: Cash Price |
$140.36
|
| Rate for Payer: Cofinity Commercial |
$122.82
|
| Rate for Payer: Cofinity Commercial |
$150.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.36
|
| Rate for Payer: Healthscope Commercial |
$157.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.13
|
| Rate for Payer: PHP Commercial |
$149.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.04
|
| Rate for Payer: Priority Health SBD |
$110.53
|
| Rate for Payer: UMR Bronson Commercial |
$64.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.59
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.66
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.77 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Aetna American Axle |
$11.48
|
| Rate for Payer: Aetna Commercial |
$15.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: Cash Price |
$14.13
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Cofinity Commercial |
$15.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.13
|
| Rate for Payer: Healthscope Commercial |
$15.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.01
|
| Rate for Payer: PHP Commercial |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.48
|
| Rate for Payer: Priority Health SBD |
$11.13
|
| Rate for Payer: UMR Bronson Commercial |
$7.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.24
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.64
|
|
|
Service Code
|
NDC 70069027205
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.77
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$7.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$32.47
|
|
|
Service Code
|
NDC 72485010905
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna American Axle |
$21.11
|
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.11
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.97
|
|
|
Service Code
|
NDC 70069027101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$17.97 |
| Rate for Payer: Aetna American Axle |
$12.98
|
| Rate for Payer: Aetna Commercial |
$16.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.98
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Cofinity Commercial |
$17.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.97
|
| Rate for Payer: PHP Commercial |
$16.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.98
|
| Rate for Payer: Priority Health SBD |
$12.58
|
| Rate for Payer: UMR Bronson Commercial |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$32.47
|
|
|
Service Code
|
NDC 72485010901
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Aetna American Axle |
$21.11
|
| Rate for Payer: Aetna Commercial |
$27.60
|
| Rate for Payer: Aetna Medicare |
$16.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: BCBS Complete |
$12.99
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$27.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: PHP Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.11
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: UMR Bronson Commercial |
$12.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.35
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.96
|
|
|
Service Code
|
NDC 70710164401
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$23.36 |
| Rate for Payer: Aetna American Axle |
$16.87
|
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: BCBS Complete |
$10.38
|
| Rate for Payer: Cash Price |
$20.77
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.87
|
| Rate for Payer: Priority Health SBD |
$16.35
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.47
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.64
|
|
|
Service Code
|
NDC 70069027201
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.77
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$7.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.82
|
|
|
Service Code
|
NDC 70069027125
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$17.84 |
| Rate for Payer: Aetna American Axle |
$12.88
|
| Rate for Payer: Aetna Commercial |
$16.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.88
|
| Rate for Payer: Cash Price |
$15.86
|
| Rate for Payer: Cofinity Commercial |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$17.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.86
|
| Rate for Payer: Healthscope Commercial |
$17.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.85
|
| Rate for Payer: PHP Commercial |
$16.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.88
|
| Rate for Payer: Priority Health SBD |
$12.49
|
| Rate for Payer: UMR Bronson Commercial |
$8.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.86
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.64
|
|
|
Service Code
|
NDC 70069027205
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$17.68 |
| Rate for Payer: Aetna American Axle |
$12.77
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.77
|
| Rate for Payer: Cash Price |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$13.75
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$17.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.69
|
| Rate for Payer: PHP Commercial |
$16.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.77
|
| Rate for Payer: Priority Health SBD |
$12.37
|
| Rate for Payer: UMR Bronson Commercial |
$8.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.73
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$36.70
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$33.03 |
| Rate for Payer: Aetna American Axle |
$23.86
|
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare |
$18.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.86
|
| Rate for Payer: BCBS Complete |
$14.68
|
| Rate for Payer: Cash Price |
$29.36
|
| Rate for Payer: Cofinity Commercial |
$25.69
|
| Rate for Payer: Cofinity Commercial |
$31.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.36
|
| Rate for Payer: Healthscope Commercial |
$33.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: PHP Commercial |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.86
|
| Rate for Payer: Priority Health SBD |
$23.12
|
| Rate for Payer: UMR Bronson Commercial |
$13.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.52
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.66
|
|
|
Service Code
|
NDC 70756060525
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Aetna American Axle |
$11.48
|
| Rate for Payer: Aetna Commercial |
$15.01
|
| Rate for Payer: Aetna Medicare |
$8.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: Cash Price |
$14.13
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Cofinity Commercial |
$15.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.13
|
| Rate for Payer: Healthscope Commercial |
$15.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.01
|
| Rate for Payer: PHP Commercial |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.48
|
| Rate for Payer: Priority Health SBD |
$11.13
|
| Rate for Payer: UMR Bronson Commercial |
$6.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.24
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.96
|
|
|
Service Code
|
NDC 70710164401
|
| Hospital Charge Code |
8527
|
|
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 |
$22.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.87
|
| Rate for Payer: Cash Price |
$20.77
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.87
|
| 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 |
$19.47
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$107.64
|
|
|
Service Code
|
NDC 00409114401
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna American Axle |
$69.97
|
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna Medicare |
$53.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: BCBS Complete |
$43.06
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$75.35
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health SBD |
$67.81
|
| Rate for Payer: UMR Bronson Commercial |
$39.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
