|
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
NDC 00186037028
|
| Hospital Charge Code |
81454
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.68 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Advantage |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.23
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$81.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
NDC 00186037028
|
| Hospital Charge Code |
81454
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Advantage |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.23
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.67
|
| Rate for Payer: UHC Core |
$96.72
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
NDC 00186037228
|
| Hospital Charge Code |
81453
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.68 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Advantage |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.23
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$81.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
NDC 00186037228
|
| Hospital Charge Code |
81453
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Advantage |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.23
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.67
|
| Rate for Payer: UHC Core |
$96.72
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUFFERED LIDOCAINE 1% SOLUTION CUSTOM
|
Facility
|
IP
|
$4.92
|
|
|
Service Code
|
NDC 00990000106
|
| Hospital Charge Code |
500546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Advantage |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.69
|
| Rate for Payer: PHP Commercial |
$4.18
|
| Rate for Payer: Priority Health SBD |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$2.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.69
|
|
|
BUFFERED LIDOCAINE 1% SOLUTION CUSTOM
|
Facility
|
OP
|
$4.92
|
|
|
Service Code
|
NDC 00990000106
|
| Hospital Charge Code |
500546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.18
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Advantage |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.69
|
| Rate for Payer: PHP Commercial |
$4.18
|
| Rate for Payer: Priority Health SBD |
$3.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.20
|
| Rate for Payer: UHC Core |
$2.56
|
| Rate for Payer: UHC Exchange |
$1.93
|
| Rate for Payer: UMR Bronson Commercial |
$1.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.69
|
|
|
BUFFERED LIDOCAINE 1% WITH EPI
|
Facility
|
OP
|
$16.56
|
|
|
Service Code
|
NDC 09900000149
|
| Hospital Charge Code |
500548
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna American Axle |
$10.76
|
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Advantage |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.42
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health SBD |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.76
|
| Rate for Payer: UHC Core |
$8.63
|
| Rate for Payer: UHC Exchange |
$6.51
|
| Rate for Payer: UMR Bronson Commercial |
$6.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
BUFFERED LIDOCAINE 1% WITH EPI
|
Facility
|
IP
|
$16.56
|
|
|
Service Code
|
NDC 09900000149
|
| Hospital Charge Code |
500548
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.29 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna American Axle |
$10.76
|
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Advantage |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.42
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health SBD |
$10.43
|
| Rate for Payer: UMR Bronson Commercial |
$7.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$23.74
|
|
|
Service Code
|
HCPCS J1939
|
| Hospital Charge Code |
9308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$21.37 |
| Rate for Payer: Aetna American Axle |
$15.43
|
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna American Axle |
$16.78
|
| Rate for Payer: Aetna American Axle |
$16.59
|
| Rate for Payer: Aetna American Axle |
$14.55
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna American Axle |
$17.63
|
| Rate for Payer: Aetna American Axle |
$17.25
|
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Commercial |
$19.03
|
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna Commercial |
$22.56
|
| Rate for Payer: Aetna Commercial |
$23.05
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Medicare |
$11.87
|
| Rate for Payer: Aetna Medicare |
$11.20
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna Medicare |
$11.18
|
| Rate for Payer: Aetna Medicare |
$14.58
|
| Rate for Payer: Aetna Medicare |
$12.76
|
| Rate for Payer: Aetna Medicare |
$12.06
|
| Rate for Payer: Aetna Medicare |
$13.56
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: BCBS Complete |
$8.96
|
| Rate for Payer: BCBS Complete |
$9.50
|
| Rate for Payer: BCBS Complete |
$10.32
|
| Rate for Payer: BCBS Complete |
$9.65
|
| Rate for Payer: BCBS Complete |
$10.62
|
| Rate for Payer: BCBS Complete |
$10.21
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS Complete |
$8.94
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$21.23
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$21.23
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$21.70
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$21.70
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cofinity Advantage |
$15.67
|
| Rate for Payer: Cofinity Advantage |
$16.62
|
| Rate for Payer: Cofinity Advantage |
$15.64
|
| Rate for Payer: Cofinity Advantage |
$16.89
|
| Rate for Payer: Cofinity Advantage |
$17.86
|
| Rate for Payer: Cofinity Advantage |
$18.07
|
| Rate for Payer: Cofinity Advantage |
$18.58
|
| Rate for Payer: Cofinity Advantage |
$18.98
|
| Rate for Payer: Cofinity Advantage |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Healthscope Commercial |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$20.11
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Healthscope Commercial |
$24.41
|
| Rate for Payer: Healthscope Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Healthscope Commercial |
$22.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.34
|
| Rate for Payer: PHP Commercial |
$20.18
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Commercial |
$21.69
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$19.03
|
| Rate for Payer: PHP Commercial |
$22.56
|
| Rate for Payer: PHP Commercial |
$23.05
|
| Rate for Payer: Priority Health SBD |
$16.08
|
| Rate for Payer: Priority Health SBD |
$16.72
|
| Rate for Payer: Priority Health SBD |
$14.11
|
| Rate for Payer: Priority Health SBD |
$14.96
|
| Rate for Payer: Priority Health SBD |
$16.26
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Priority Health SBD |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Core |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UMR Bronson Commercial |
$9.55
|
| Rate for Payer: UMR Bronson Commercial |
$8.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: UMR Bronson Commercial |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$10.79
|
| Rate for Payer: UMR Bronson Commercial |
$8.27
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
| Rate for Payer: UMR Bronson Commercial |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.79
|
|
|
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$25.52
|
|
|
Service Code
|
HCPCS J1939
|
| Hospital Charge Code |
9308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$22.97 |
| Rate for Payer: Aetna American Axle |
$16.59
|
| Rate for Payer: Aetna American Axle |
$17.25
|
| Rate for Payer: Aetna American Axle |
$17.63
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna American Axle |
$15.43
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna American Axle |
$16.78
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Commercial |
$23.05
|
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Commercial |
$22.56
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.25
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cash Price |
$21.23
|
| Rate for Payer: Cash Price |
$21.70
|
| Rate for Payer: Cofinity Advantage |
$20.41
|
| Rate for Payer: Cofinity Advantage |
$16.62
|
| Rate for Payer: Cofinity Advantage |
$17.86
|
| Rate for Payer: Cofinity Advantage |
$16.89
|
| Rate for Payer: Cofinity Advantage |
$15.64
|
| Rate for Payer: Cofinity Advantage |
$18.58
|
| Rate for Payer: Cofinity Advantage |
$18.98
|
| Rate for Payer: Cofinity Advantage |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Cofinity Commercial |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Healthscope Commercial |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$20.11
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$24.41
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Healthscope Commercial |
$23.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.87
|
| Rate for Payer: PHP Commercial |
$21.69
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Commercial |
$20.18
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$22.56
|
| Rate for Payer: PHP Commercial |
$23.05
|
| Rate for Payer: Priority Health SBD |
$16.72
|
| Rate for Payer: Priority Health SBD |
$17.09
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$14.96
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Priority Health SBD |
$16.08
|
| Rate for Payer: Priority Health SBD |
$16.26
|
| Rate for Payer: UMR Bronson Commercial |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$11.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.62
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: UMR Bronson Commercial |
$11.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.23
|
| Rate for Payer: UMR Bronson Commercial |
$10.45
|
| Rate for Payer: UMR Bronson Commercial |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.34
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$398.05
|
|
|
Service Code
|
NDC 00185012801
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.14 |
| Max. Negotiated Rate |
$358.25 |
| Rate for Payer: Aetna American Axle |
$258.73
|
| Rate for Payer: Aetna Commercial |
$338.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.73
|
| Rate for Payer: Cash Price |
$318.44
|
| Rate for Payer: Cofinity Advantage |
$278.63
|
| Rate for Payer: Cofinity Commercial |
$342.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.44
|
| Rate for Payer: Healthscope Commercial |
$358.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.54
|
| Rate for Payer: PHP Commercial |
$338.34
|
| Rate for Payer: Priority Health SBD |
$250.77
|
| Rate for Payer: UMR Bronson Commercial |
$175.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.54
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$241.30
|
|
|
Service Code
|
NDC 69238148901
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$217.17 |
| Rate for Payer: Aetna American Axle |
$156.84
|
| Rate for Payer: Aetna Commercial |
$205.10
|
| Rate for Payer: Aetna Medicare |
$120.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.84
|
| Rate for Payer: BCBS Complete |
$96.52
|
| Rate for Payer: Cash Price |
$193.04
|
| Rate for Payer: Cofinity Advantage |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.04
|
| Rate for Payer: Healthscope Commercial |
$217.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.97
|
| Rate for Payer: PHP Commercial |
$205.10
|
| Rate for Payer: Priority Health SBD |
$152.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.84
|
| Rate for Payer: UHC Core |
$125.72
|
| Rate for Payer: UHC Exchange |
$94.83
|
| Rate for Payer: UMR Bronson Commercial |
$89.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.97
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$398.05
|
|
|
Service Code
|
NDC 00185012801
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.28 |
| Max. Negotiated Rate |
$358.25 |
| Rate for Payer: Aetna American Axle |
$258.73
|
| Rate for Payer: Aetna Commercial |
$338.34
|
| Rate for Payer: Aetna Medicare |
$199.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.73
|
| Rate for Payer: BCBS Complete |
$159.22
|
| Rate for Payer: Cash Price |
$318.44
|
| Rate for Payer: Cofinity Advantage |
$278.63
|
| Rate for Payer: Cofinity Commercial |
$342.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.44
|
| Rate for Payer: Healthscope Commercial |
$358.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$318.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.54
|
| Rate for Payer: PHP Commercial |
$338.34
|
| Rate for Payer: Priority Health SBD |
$250.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.73
|
| Rate for Payer: UHC Core |
$207.38
|
| Rate for Payer: UHC Exchange |
$156.43
|
| Rate for Payer: UMR Bronson Commercial |
$147.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.54
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$241.30
|
|
|
Service Code
|
NDC 69238148901
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.17 |
| Max. Negotiated Rate |
$217.17 |
| Rate for Payer: Aetna American Axle |
$156.84
|
| Rate for Payer: Aetna Commercial |
$205.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.84
|
| Rate for Payer: Cash Price |
$193.04
|
| Rate for Payer: Cofinity Advantage |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.04
|
| Rate for Payer: Healthscope Commercial |
$217.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.97
|
| Rate for Payer: PHP Commercial |
$205.10
|
| Rate for Payer: Priority Health SBD |
$152.02
|
| Rate for Payer: UMR Bronson Commercial |
$106.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.97
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$294.00
|
|
|
Service Code
|
NDC 50268013015
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$264.60 |
| Rate for Payer: Aetna American Axle |
$191.10
|
| Rate for Payer: Aetna Commercial |
$249.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.10
|
| Rate for Payer: Cash Price |
$235.20
|
| Rate for Payer: Cofinity Advantage |
$205.80
|
| Rate for Payer: Cofinity Commercial |
$252.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.20
|
| Rate for Payer: Healthscope Commercial |
$264.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.50
|
| Rate for Payer: PHP Commercial |
$249.90
|
| Rate for Payer: Priority Health SBD |
$185.22
|
| Rate for Payer: UMR Bronson Commercial |
$129.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.50
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$5.88
|
|
|
Service Code
|
NDC 50268013011
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$5.29 |
| Rate for Payer: Aetna American Axle |
$3.82
|
| Rate for Payer: Aetna Commercial |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cofinity Advantage |
$4.12
|
| Rate for Payer: Cofinity Commercial |
$5.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.70
|
| Rate for Payer: Healthscope Commercial |
$5.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.41
|
| Rate for Payer: PHP Commercial |
$5.00
|
| Rate for Payer: Priority Health SBD |
$3.70
|
| Rate for Payer: UMR Bronson Commercial |
$2.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.41
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$294.00
|
|
|
Service Code
|
NDC 50268013015
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.78 |
| Max. Negotiated Rate |
$264.60 |
| Rate for Payer: Aetna American Axle |
$191.10
|
| Rate for Payer: Aetna Commercial |
$249.90
|
| Rate for Payer: Aetna Medicare |
$147.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.10
|
| Rate for Payer: BCBS Complete |
$117.60
|
| Rate for Payer: Cash Price |
$235.20
|
| Rate for Payer: Cofinity Advantage |
$205.80
|
| Rate for Payer: Cofinity Commercial |
$252.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.20
|
| Rate for Payer: Healthscope Commercial |
$264.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.50
|
| Rate for Payer: PHP Commercial |
$249.90
|
| Rate for Payer: Priority Health SBD |
$185.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.10
|
| Rate for Payer: UHC Core |
$153.17
|
| Rate for Payer: UHC Exchange |
$115.54
|
| Rate for Payer: UMR Bronson Commercial |
$108.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.50
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$5.88
|
|
|
Service Code
|
NDC 50268013011
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$5.29 |
| Rate for Payer: Aetna American Axle |
$3.82
|
| Rate for Payer: Aetna Commercial |
$5.00
|
| Rate for Payer: Aetna Medicare |
$2.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cofinity Advantage |
$4.12
|
| Rate for Payer: Cofinity Commercial |
$5.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.70
|
| Rate for Payer: Healthscope Commercial |
$5.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.41
|
| Rate for Payer: PHP Commercial |
$5.00
|
| Rate for Payer: Priority Health SBD |
$3.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.82
|
| Rate for Payer: UHC Core |
$3.06
|
| Rate for Payer: UHC Exchange |
$2.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.41
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$400.90
|
|
|
Service Code
|
NDC 00185012901
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$360.81 |
| Rate for Payer: Aetna American Axle |
$260.58
|
| Rate for Payer: Aetna Commercial |
$340.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.58
|
| Rate for Payer: Cash Price |
$320.72
|
| Rate for Payer: Cofinity Advantage |
$280.63
|
| Rate for Payer: Cofinity Commercial |
$344.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.72
|
| Rate for Payer: Healthscope Commercial |
$360.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.68
|
| Rate for Payer: PHP Commercial |
$340.76
|
| Rate for Payer: Priority Health SBD |
$252.57
|
| Rate for Payer: UMR Bronson Commercial |
$176.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.68
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$260.30
|
|
|
Service Code
|
NDC 69238149001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$234.27 |
| Rate for Payer: Aetna American Axle |
$169.19
|
| Rate for Payer: Aetna Commercial |
$221.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.19
|
| Rate for Payer: Cash Price |
$208.24
|
| Rate for Payer: Cofinity Advantage |
$182.21
|
| Rate for Payer: Cofinity Commercial |
$223.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.24
|
| Rate for Payer: Healthscope Commercial |
$234.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.22
|
| Rate for Payer: PHP Commercial |
$221.25
|
| Rate for Payer: Priority Health SBD |
$163.99
|
| Rate for Payer: UMR Bronson Commercial |
$114.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.22
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$300.20
|
|
|
Service Code
|
NDC 42799012001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna Medicare |
$150.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: BCBS Complete |
$120.08
|
| Rate for Payer: Cash Price |
$240.16
|
| Rate for Payer: Cofinity Advantage |
$210.14
|
| Rate for Payer: Cofinity Commercial |
$258.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$270.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.15
|
| Rate for Payer: PHP Commercial |
$255.17
|
| Rate for Payer: Priority Health SBD |
$189.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.13
|
| Rate for Payer: UHC Core |
$156.40
|
| Rate for Payer: UHC Exchange |
$117.98
|
| Rate for Payer: UMR Bronson Commercial |
$111.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$260.30
|
|
|
Service Code
|
NDC 69238149001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$234.27 |
| Rate for Payer: Aetna American Axle |
$169.19
|
| Rate for Payer: Aetna Commercial |
$221.25
|
| Rate for Payer: Aetna Medicare |
$130.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.19
|
| Rate for Payer: BCBS Complete |
$104.12
|
| Rate for Payer: Cash Price |
$208.24
|
| Rate for Payer: Cofinity Advantage |
$182.21
|
| Rate for Payer: Cofinity Commercial |
$223.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.24
|
| Rate for Payer: Healthscope Commercial |
$234.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.22
|
| Rate for Payer: PHP Commercial |
$221.25
|
| Rate for Payer: Priority Health SBD |
$163.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.19
|
| Rate for Payer: UHC Core |
$135.62
|
| Rate for Payer: UHC Exchange |
$102.30
|
| Rate for Payer: UMR Bronson Commercial |
$96.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.22
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$300.20
|
|
|
Service Code
|
NDC 42799012001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.09 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: Cash Price |
$240.16
|
| Rate for Payer: Cofinity Advantage |
$210.14
|
| Rate for Payer: Cofinity Commercial |
$258.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$270.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.15
|
| Rate for Payer: PHP Commercial |
$255.17
|
| Rate for Payer: Priority Health SBD |
$189.13
|
| Rate for Payer: UMR Bronson Commercial |
$132.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$441.12
|
|
|
Service Code
|
NDC 00904701661
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.21 |
| Max. Negotiated Rate |
$397.01 |
| Rate for Payer: Aetna American Axle |
$286.73
|
| Rate for Payer: Aetna Commercial |
$374.95
|
| Rate for Payer: Aetna Medicare |
$220.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.73
|
| Rate for Payer: BCBS Complete |
$176.45
|
| Rate for Payer: Cash Price |
$352.90
|
| Rate for Payer: Cofinity Advantage |
$308.78
|
| Rate for Payer: Cofinity Commercial |
$379.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.90
|
| Rate for Payer: Healthscope Commercial |
$397.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.84
|
| Rate for Payer: PHP Commercial |
$374.95
|
| Rate for Payer: Priority Health SBD |
$277.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.73
|
| Rate for Payer: UHC Core |
$229.82
|
| Rate for Payer: UHC Exchange |
$173.36
|
| Rate for Payer: UMR Bronson Commercial |
$163.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.84
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$400.90
|
|
|
Service Code
|
NDC 00185012901
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.33 |
| Max. Negotiated Rate |
$360.81 |
| Rate for Payer: Aetna American Axle |
$260.58
|
| Rate for Payer: Aetna Commercial |
$340.76
|
| Rate for Payer: Aetna Medicare |
$200.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.58
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: Cash Price |
$320.72
|
| Rate for Payer: Cofinity Advantage |
$280.63
|
| Rate for Payer: Cofinity Commercial |
$344.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.72
|
| Rate for Payer: Healthscope Commercial |
$360.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.68
|
| Rate for Payer: PHP Commercial |
$340.76
|
| Rate for Payer: Priority Health SBD |
$252.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.58
|
| Rate for Payer: UHC Core |
$208.87
|
| Rate for Payer: UHC Exchange |
$157.55
|
| Rate for Payer: UMR Bronson Commercial |
$148.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.68
|
|
