|
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
|
$22.77
|
|
|
Service Code
|
NDC 43066003501
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$11.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.80
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$8.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$36.70
|
|
|
Service Code
|
NDC 00409401101
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$33.03 |
| Rate for Payer: Aetna American Axle |
$23.86
|
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.86
|
| 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 |
$16.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.52
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.27
|
|
|
Service Code
|
NDC 70756060582
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$16.44 |
| Rate for Payer: Aetna American Axle |
$11.88
|
| Rate for Payer: Aetna Commercial |
$15.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cofinity Commercial |
$12.79
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Healthscope Commercial |
$16.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.53
|
| Rate for Payer: PHP Commercial |
$15.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.88
|
| Rate for Payer: Priority Health SBD |
$11.51
|
| Rate for Payer: UMR Bronson Commercial |
$8.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.70
|
|
|
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
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.02
|
|
|
Service Code
|
NDC 70756060605
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$18.92 |
| Rate for Payer: Aetna American Axle |
$13.66
|
| Rate for Payer: Aetna Commercial |
$17.87
|
| Rate for Payer: Aetna Medicare |
$10.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.66
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Cofinity Commercial |
$18.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.87
|
| Rate for Payer: PHP Commercial |
$17.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.66
|
| Rate for Payer: Priority Health SBD |
$13.24
|
| Rate for Payer: UMR Bronson Commercial |
$7.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.76
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$37.25
|
|
|
Service Code
|
NDC 51754020304
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$26.08
|
| Rate for Payer: Cofinity Commercial |
$32.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.77
|
|
|
Service Code
|
NDC 43066003505
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$11.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.80
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$8.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$113.40
|
|
|
Service Code
|
NDC 00409114405
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna American Axle |
$73.71
|
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$56.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.71
|
| Rate for Payer: BCBS Complete |
$45.36
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health SBD |
$71.44
|
| Rate for Payer: UMR Bronson Commercial |
$41.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.05
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.91
|
|
|
Service Code
|
NDC 55150034301
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$16.12 |
| Rate for Payer: Aetna American Axle |
$11.64
|
| Rate for Payer: Aetna Commercial |
$15.22
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.64
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: Cash Price |
$14.33
|
| Rate for Payer: Cofinity Commercial |
$12.54
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.33
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.22
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.64
|
| Rate for Payer: Priority Health SBD |
$11.28
|
| Rate for Payer: UMR Bronson Commercial |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.43
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.91
|
|
|
Service Code
|
NDC 55150034305
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$16.12 |
| Rate for Payer: Aetna American Axle |
$11.64
|
| Rate for Payer: Aetna Commercial |
$15.22
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.64
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: Cash Price |
$14.33
|
| Rate for Payer: Cofinity Commercial |
$12.54
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.33
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.22
|
| Rate for Payer: PHP Commercial |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.64
|
| Rate for Payer: Priority Health SBD |
$11.28
|
| Rate for Payer: UMR Bronson Commercial |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.43
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$37.25
|
|
|
Service Code
|
NDC 51754020301
|
| Hospital Charge Code |
8527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.78 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$26.08
|
| Rate for Payer: Cofinity Commercial |
$32.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$141.24 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna Medicare |
$190.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: BCBS Complete |
$152.70
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Commercial |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.13
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UMR Bronson Commercial |
$141.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.30
|
|
|
VERAPAMIL 2.5 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$381.74
|
|
|
Service Code
|
NDC 00409963305
|
| Hospital Charge Code |
112139
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$167.97 |
| Max. Negotiated Rate |
$343.57 |
| Rate for Payer: Aetna American Axle |
$248.13
|
| Rate for Payer: Aetna Commercial |
$324.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.13
|
| Rate for Payer: Cash Price |
$305.39
|
| Rate for Payer: Cofinity Commercial |
$267.22
|
| Rate for Payer: Cofinity Commercial |
$328.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.39
|
| Rate for Payer: Healthscope Commercial |
$343.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.48
|
| Rate for Payer: PHP Commercial |
$324.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.13
|
| Rate for Payer: Priority Health SBD |
$240.50
|
| Rate for Payer: UMR Bronson Commercial |
$167.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.30
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$345.45
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.00 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.82
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$152.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$345.45
|
|
|
Service Code
|
NDC 00591040401
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.82 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna Medicare |
$172.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: BCBS Complete |
$138.18
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.82
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$127.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.49 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$136.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
VERAPAMIL 40 MG TABLET
|
Facility
|
OP
|
$310.20
|
|
|
Service Code
|
NDC 23155005901
|
| Hospital Charge Code |
8529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.77 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna Medicare |
$155.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: BCBS Complete |
$124.08
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$114.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
IP
|
$1,324.60
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$582.82 |
| Max. Negotiated Rate |
$1,192.14 |
| Rate for Payer: Aetna American Axle |
$860.99
|
| Rate for Payer: Aetna Commercial |
$1,125.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.99
|
| Rate for Payer: Cash Price |
$1,059.68
|
| Rate for Payer: Cofinity Commercial |
$1,139.16
|
| Rate for Payer: Cofinity Commercial |
$927.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$927.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.68
|
| Rate for Payer: Healthscope Commercial |
$1,192.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,125.91
|
| Rate for Payer: PHP Commercial |
$1,125.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$860.99
|
| Rate for Payer: Priority Health SBD |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$582.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.45
|
|
|
VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE
|
Facility
|
OP
|
$1,324.60
|
|
|
Service Code
|
NDC 62175048537
|
| Hospital Charge Code |
88029
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$490.10 |
| Max. Negotiated Rate |
$1,192.14 |
| Rate for Payer: Aetna American Axle |
$860.99
|
| Rate for Payer: Aetna Commercial |
$1,125.91
|
| Rate for Payer: Aetna Medicare |
$662.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.99
|
| Rate for Payer: BCBS Complete |
$529.84
|
| Rate for Payer: Cash Price |
$1,059.68
|
| Rate for Payer: Cofinity Commercial |
$1,139.16
|
| Rate for Payer: Cofinity Commercial |
$927.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$927.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.68
|
| Rate for Payer: Healthscope Commercial |
$1,192.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,125.91
|
| Rate for Payer: PHP Commercial |
$1,125.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$860.99
|
| Rate for Payer: Priority Health SBD |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$490.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.45
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.25
|
|
|
Service Code
|
NDC 60687049311
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.41
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$524.64
|
|
|
Service Code
|
NDC 60687049301
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$230.84 |
| Max. Negotiated Rate |
$472.18 |
| Rate for Payer: Aetna American Axle |
$341.02
|
| Rate for Payer: Aetna Commercial |
$445.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.02
|
| Rate for Payer: Cash Price |
$419.71
|
| Rate for Payer: Cofinity Commercial |
$367.25
|
| Rate for Payer: Cofinity Commercial |
$451.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$367.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.71
|
| Rate for Payer: Healthscope Commercial |
$472.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.94
|
| Rate for Payer: PHP Commercial |
$445.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.02
|
| Rate for Payer: Priority Health SBD |
$330.52
|
| Rate for Payer: UMR Bronson Commercial |
$230.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.48
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$180.40 |
| Rate for Payer: Aetna American Axle |
$130.29
|
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$140.32
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health SBD |
$126.28
|
| Rate for Payer: UMR Bronson Commercial |
$88.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
|
VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$200.45
|
|
|
Service Code
|
NDC 68462029201
|
| Hospital Charge Code |
11639
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.17 |
| Max. Negotiated Rate |
$180.40 |
| Rate for Payer: Aetna American Axle |
$130.29
|
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: BCBS Complete |
$80.18
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Commercial |
$140.32
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.29
|
| Rate for Payer: Priority Health SBD |
$126.28
|
| Rate for Payer: UMR Bronson Commercial |
$74.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.34
|
|
