|
BUSPIRONE 15 MG TABLET
|
Facility
|
IP
|
$195.05
|
|
|
Service Code
|
NDC 68382018201
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$175.54 |
| Rate for Payer: Aetna American Axle |
$126.78
|
| Rate for Payer: Aetna Commercial |
$165.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.78
|
| Rate for Payer: Cash Price |
$156.04
|
| Rate for Payer: Cofinity Advantage |
$136.53
|
| Rate for Payer: Cofinity Commercial |
$167.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.04
|
| Rate for Payer: Healthscope Commercial |
$175.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.29
|
| Rate for Payer: PHP Commercial |
$165.79
|
| Rate for Payer: Priority Health SBD |
$122.88
|
| Rate for Payer: UMR Bronson Commercial |
$85.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.29
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
OP
|
$195.05
|
|
|
Service Code
|
NDC 68382018201
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.17 |
| Max. Negotiated Rate |
$175.54 |
| Rate for Payer: Aetna American Axle |
$126.78
|
| Rate for Payer: Aetna Commercial |
$165.79
|
| Rate for Payer: Aetna Medicare |
$97.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.78
|
| Rate for Payer: BCBS Complete |
$78.02
|
| Rate for Payer: Cash Price |
$156.04
|
| Rate for Payer: Cofinity Advantage |
$136.53
|
| Rate for Payer: Cofinity Commercial |
$167.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.04
|
| Rate for Payer: Healthscope Commercial |
$175.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.29
|
| Rate for Payer: PHP Commercial |
$165.79
|
| Rate for Payer: Priority Health SBD |
$122.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.78
|
| Rate for Payer: UHC Core |
$101.62
|
| Rate for Payer: UHC Exchange |
$76.65
|
| Rate for Payer: UMR Bronson Commercial |
$72.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.29
|
|
|
BUSPIRONE 15 MG TABLET
|
Facility
|
OP
|
$4.03
|
|
|
Service Code
|
NDC 60687082311
|
| Hospital Charge Code |
17464
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$3.63 |
| Rate for Payer: Aetna American Axle |
$2.62
|
| Rate for Payer: Aetna Commercial |
$3.43
|
| Rate for Payer: Aetna Medicare |
$2.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.62
|
| Rate for Payer: BCBS Complete |
$1.61
|
| Rate for Payer: Cash Price |
$3.22
|
| Rate for Payer: Cofinity Advantage |
$2.82
|
| Rate for Payer: Cofinity Commercial |
$3.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.22
|
| Rate for Payer: Healthscope Commercial |
$3.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.02
|
| Rate for Payer: PHP Commercial |
$3.43
|
| Rate for Payer: Priority Health SBD |
$2.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.62
|
| Rate for Payer: UHC Core |
$2.10
|
| Rate for Payer: UHC Exchange |
$1.58
|
| Rate for Payer: UMR Bronson Commercial |
$1.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.02
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
IP
|
$132.81
|
|
|
Service Code
|
NDC 24689093306
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.44 |
| Max. Negotiated Rate |
$119.53 |
| Rate for Payer: Aetna American Axle |
$86.33
|
| Rate for Payer: Aetna Commercial |
$112.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.33
|
| Rate for Payer: Cash Price |
$106.25
|
| Rate for Payer: Cofinity Advantage |
$92.97
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.25
|
| Rate for Payer: Healthscope Commercial |
$119.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.61
|
| Rate for Payer: PHP Commercial |
$112.89
|
| Rate for Payer: Priority Health SBD |
$83.67
|
| Rate for Payer: UMR Bronson Commercial |
$58.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.61
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
OP
|
$132.81
|
|
|
Service Code
|
NDC 24689093306
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.14 |
| Max. Negotiated Rate |
$119.53 |
| Rate for Payer: Aetna American Axle |
$86.33
|
| Rate for Payer: Aetna Commercial |
$112.89
|
| Rate for Payer: Aetna Medicare |
$66.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.33
|
| Rate for Payer: BCBS Complete |
$53.12
|
| Rate for Payer: Cash Price |
$106.25
|
| Rate for Payer: Cofinity Advantage |
$92.97
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.25
|
| Rate for Payer: Healthscope Commercial |
$119.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.61
|
| Rate for Payer: PHP Commercial |
$112.89
|
| Rate for Payer: Priority Health SBD |
$83.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.33
|
| Rate for Payer: UHC Core |
$69.19
|
| Rate for Payer: UHC Exchange |
$52.19
|
| Rate for Payer: UMR Bronson Commercial |
$49.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.61
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
IP
|
$253.16
|
|
|
Service Code
|
NDC 00093520006
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.39 |
| Max. Negotiated Rate |
$227.84 |
| Rate for Payer: Aetna American Axle |
$164.55
|
| Rate for Payer: Aetna Commercial |
$215.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.55
|
| Rate for Payer: Cash Price |
$202.53
|
| Rate for Payer: Cofinity Advantage |
$177.21
|
| Rate for Payer: Cofinity Commercial |
$217.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.53
|
| Rate for Payer: Healthscope Commercial |
$227.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.87
|
| Rate for Payer: PHP Commercial |
$215.19
|
| Rate for Payer: Priority Health SBD |
$159.49
|
| Rate for Payer: UMR Bronson Commercial |
$111.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.87
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
OP
|
$5.02
|
|
|
Service Code
|
NDC 51079099401
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.86 |
| Max. Negotiated Rate |
$4.52 |
| Rate for Payer: Aetna American Axle |
$3.26
|
| Rate for Payer: Aetna Commercial |
$4.27
|
| Rate for Payer: Aetna Medicare |
$2.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.26
|
| Rate for Payer: BCBS Complete |
$2.01
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Cofinity Advantage |
$3.51
|
| Rate for Payer: Cofinity Commercial |
$4.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$4.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.77
|
| Rate for Payer: PHP Commercial |
$4.27
|
| Rate for Payer: Priority Health SBD |
$3.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$2.62
|
| Rate for Payer: UHC Exchange |
$1.97
|
| Rate for Payer: UMR Bronson Commercial |
$1.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.77
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
IP
|
$177.27
|
|
|
Service Code
|
NDC 68382018314
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$159.54 |
| Rate for Payer: Aetna American Axle |
$115.23
|
| Rate for Payer: Aetna Commercial |
$150.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.23
|
| Rate for Payer: Cash Price |
$141.82
|
| Rate for Payer: Cofinity Advantage |
$124.09
|
| Rate for Payer: Cofinity Commercial |
$152.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.82
|
| Rate for Payer: Healthscope Commercial |
$159.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.95
|
| Rate for Payer: PHP Commercial |
$150.68
|
| Rate for Payer: Priority Health SBD |
$111.68
|
| Rate for Payer: UMR Bronson Commercial |
$78.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.95
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
OP
|
$501.60
|
|
|
Service Code
|
NDC 51079099420
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$185.59 |
| Max. Negotiated Rate |
$451.44 |
| Rate for Payer: Aetna American Axle |
$326.04
|
| Rate for Payer: Aetna Commercial |
$426.36
|
| Rate for Payer: Aetna Medicare |
$250.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.04
|
| Rate for Payer: BCBS Complete |
$200.64
|
| Rate for Payer: Cash Price |
$401.28
|
| Rate for Payer: Cofinity Advantage |
$351.12
|
| Rate for Payer: Cofinity Commercial |
$431.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.28
|
| Rate for Payer: Healthscope Commercial |
$451.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$351.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$401.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$376.20
|
| Rate for Payer: PHP Commercial |
$426.36
|
| Rate for Payer: Priority Health SBD |
$316.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.04
|
| Rate for Payer: UHC Core |
$261.33
|
| Rate for Payer: UHC Exchange |
$197.13
|
| Rate for Payer: UMR Bronson Commercial |
$185.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.20
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
IP
|
$501.60
|
|
|
Service Code
|
NDC 51079099420
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$220.70 |
| Max. Negotiated Rate |
$451.44 |
| Rate for Payer: Aetna American Axle |
$326.04
|
| Rate for Payer: Aetna Commercial |
$426.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.04
|
| Rate for Payer: Cash Price |
$401.28
|
| Rate for Payer: Cofinity Advantage |
$351.12
|
| Rate for Payer: Cofinity Commercial |
$431.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.28
|
| Rate for Payer: Healthscope Commercial |
$451.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$351.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$376.20
|
| Rate for Payer: PHP Commercial |
$426.36
|
| Rate for Payer: Priority Health SBD |
$316.01
|
| Rate for Payer: UMR Bronson Commercial |
$220.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.20
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
IP
|
$5.02
|
|
|
Service Code
|
NDC 51079099401
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$4.52 |
| Rate for Payer: Aetna American Axle |
$3.26
|
| Rate for Payer: Aetna Commercial |
$4.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.26
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Cofinity Advantage |
$3.51
|
| Rate for Payer: Cofinity Commercial |
$4.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$4.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.77
|
| Rate for Payer: PHP Commercial |
$4.27
|
| Rate for Payer: Priority Health SBD |
$3.16
|
| Rate for Payer: UMR Bronson Commercial |
$2.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.77
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
OP
|
$177.27
|
|
|
Service Code
|
NDC 68382018314
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.59 |
| Max. Negotiated Rate |
$159.54 |
| Rate for Payer: Aetna American Axle |
$115.23
|
| Rate for Payer: Aetna Commercial |
$150.68
|
| Rate for Payer: Aetna Medicare |
$88.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.23
|
| Rate for Payer: BCBS Complete |
$70.91
|
| Rate for Payer: Cash Price |
$141.82
|
| Rate for Payer: Cofinity Advantage |
$124.09
|
| Rate for Payer: Cofinity Commercial |
$152.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.82
|
| Rate for Payer: Healthscope Commercial |
$159.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.95
|
| Rate for Payer: PHP Commercial |
$150.68
|
| Rate for Payer: Priority Health SBD |
$111.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.23
|
| Rate for Payer: UHC Core |
$92.36
|
| Rate for Payer: UHC Exchange |
$69.67
|
| Rate for Payer: UMR Bronson Commercial |
$65.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.95
|
|
|
BUSPIRONE 30 MG TABLET
|
Facility
|
OP
|
$253.16
|
|
|
Service Code
|
NDC 00093520006
|
| Hospital Charge Code |
27046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.67 |
| Max. Negotiated Rate |
$227.84 |
| Rate for Payer: Aetna American Axle |
$164.55
|
| Rate for Payer: Aetna Commercial |
$215.19
|
| Rate for Payer: Aetna Medicare |
$126.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.55
|
| Rate for Payer: BCBS Complete |
$101.26
|
| Rate for Payer: Cash Price |
$202.53
|
| Rate for Payer: Cofinity Advantage |
$177.21
|
| Rate for Payer: Cofinity Commercial |
$217.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.53
|
| Rate for Payer: Healthscope Commercial |
$227.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.87
|
| Rate for Payer: PHP Commercial |
$215.19
|
| Rate for Payer: Priority Health SBD |
$159.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.55
|
| Rate for Payer: UHC Core |
$131.90
|
| Rate for Payer: UHC Exchange |
$99.49
|
| Rate for Payer: UMR Bronson Commercial |
$93.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.87
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$65.80
|
|
|
Service Code
|
NDC 16729020001
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.35 |
| Max. Negotiated Rate |
$59.22 |
| Rate for Payer: Aetna American Axle |
$42.77
|
| Rate for Payer: Aetna Commercial |
$55.93
|
| Rate for Payer: Aetna Medicare |
$32.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.77
|
| Rate for Payer: BCBS Complete |
$26.32
|
| Rate for Payer: Cash Price |
$52.64
|
| Rate for Payer: Cofinity Advantage |
$46.06
|
| Rate for Payer: Cofinity Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.64
|
| Rate for Payer: Healthscope Commercial |
$59.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.35
|
| Rate for Payer: PHP Commercial |
$55.93
|
| Rate for Payer: Priority Health SBD |
$41.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.77
|
| Rate for Payer: UHC Core |
$34.28
|
| Rate for Payer: UHC Exchange |
$25.86
|
| Rate for Payer: UMR Bronson Commercial |
$24.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.35
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$112.80
|
|
|
Service Code
|
NDC 00093005301
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$101.52 |
| Rate for Payer: Aetna American Axle |
$73.32
|
| Rate for Payer: Aetna Commercial |
$95.88
|
| Rate for Payer: Aetna Medicare |
$56.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.32
|
| Rate for Payer: BCBS Complete |
$45.12
|
| Rate for Payer: Cash Price |
$90.24
|
| Rate for Payer: Cofinity Advantage |
$78.96
|
| Rate for Payer: Cofinity Commercial |
$97.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.24
|
| Rate for Payer: Healthscope Commercial |
$101.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.60
|
| Rate for Payer: PHP Commercial |
$95.88
|
| Rate for Payer: Priority Health SBD |
$71.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.32
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: UHC Exchange |
$44.33
|
| Rate for Payer: UMR Bronson Commercial |
$41.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.60
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 59651038901
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.13 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: BCBS Complete |
$42.30
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.74
|
| Rate for Payer: UHC Core |
$55.10
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UMR Bronson Commercial |
$39.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$112.80
|
|
|
Service Code
|
NDC 00093005301
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$101.52 |
| Rate for Payer: Aetna American Axle |
$73.32
|
| Rate for Payer: Aetna Commercial |
$95.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.32
|
| Rate for Payer: Cash Price |
$90.24
|
| Rate for Payer: Cofinity Advantage |
$78.96
|
| Rate for Payer: Cofinity Commercial |
$97.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.24
|
| Rate for Payer: Healthscope Commercial |
$101.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.60
|
| Rate for Payer: PHP Commercial |
$95.88
|
| Rate for Payer: Priority Health SBD |
$71.06
|
| Rate for Payer: UMR Bronson Commercial |
$49.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.60
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 59651038901
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UMR Bronson Commercial |
$46.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 64380074106
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UMR Bronson Commercial |
$46.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 64380074106
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.13 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: BCBS Complete |
$42.30
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.74
|
| Rate for Payer: UHC Core |
$55.10
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UMR Bronson Commercial |
$39.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
BUSPIRONE 5 MG TABLET
|
Facility
|
IP
|
$65.80
|
|
|
Service Code
|
NDC 16729020001
|
| Hospital Charge Code |
9324
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$59.22 |
| Rate for Payer: Aetna American Axle |
$42.77
|
| Rate for Payer: Aetna Commercial |
$55.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.77
|
| Rate for Payer: Cash Price |
$52.64
|
| Rate for Payer: Cofinity Advantage |
$46.06
|
| Rate for Payer: Cofinity Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.64
|
| Rate for Payer: Healthscope Commercial |
$59.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.35
|
| Rate for Payer: PHP Commercial |
$55.93
|
| Rate for Payer: Priority Health SBD |
$41.45
|
| Rate for Payer: UMR Bronson Commercial |
$28.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.35
|
|
|
BUSPIRONE 7.5 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 64380078706
|
| Hospital Charge Code |
29967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$99.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
BUSPIRONE 7.5 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 16729020101
|
| Hospital Charge Code |
29967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$99.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
BUSPIRONE 7.5 MG TABLET
|
Facility
|
OP
|
$225.15
|
|
|
Service Code
|
NDC 68382062301
|
| Hospital Charge Code |
29967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.31 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna Medicare |
$112.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: BCBS Complete |
$90.06
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.35
|
| Rate for Payer: UHC Core |
$117.30
|
| Rate for Payer: UHC Exchange |
$88.48
|
| Rate for Payer: UMR Bronson Commercial |
$83.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
BUSPIRONE 7.5 MG TABLET
|
Facility
|
IP
|
$298.45
|
|
|
Service Code
|
NDC 72888006301
|
| Hospital Charge Code |
29967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.32 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna American Axle |
$193.99
|
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.99
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Advantage |
$208.91
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.84
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: Priority Health SBD |
$188.02
|
| Rate for Payer: UMR Bronson Commercial |
$131.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
