|
NALOXONE 0.4 MG/ML INJECTION (CODE)
|
Facility
|
OP
|
$63.57
|
|
|
Service Code
|
HCPCS J2312
|
| Hospital Charge Code |
163714
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$57.21 |
| Rate for Payer: Aetna American Axle |
$41.32
|
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: Aetna Medicare |
$31.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.32
|
| Rate for Payer: BCBS Complete |
$25.43
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Advantage |
$44.50
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.68
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: Priority Health SBD |
$40.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UMR Bronson Commercial |
$23.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
|
|
NALOXONE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$54.20
|
|
|
Service Code
|
HCPCS J2312
|
| Hospital Charge Code |
5373
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$48.78 |
| Rate for Payer: Aetna American Axle |
$35.23
|
| Rate for Payer: Aetna American Axle |
$10.97
|
| Rate for Payer: Aetna American Axle |
$13.02
|
| Rate for Payer: Aetna American Axle |
$18.12
|
| Rate for Payer: Aetna American Axle |
$12.70
|
| Rate for Payer: Aetna American Axle |
$63.67
|
| Rate for Payer: Aetna American Axle |
$41.32
|
| Rate for Payer: Aetna Commercial |
$83.26
|
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Commercial |
$23.70
|
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna Commercial |
$46.07
|
| Rate for Payer: Aetna Commercial |
$16.61
|
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Aetna Medicare |
$48.98
|
| Rate for Payer: Aetna Medicare |
$27.10
|
| Rate for Payer: Aetna Medicare |
$31.79
|
| Rate for Payer: Aetna Medicare |
$13.94
|
| Rate for Payer: Aetna Medicare |
$9.77
|
| Rate for Payer: Aetna Medicare |
$10.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.32
|
| Rate for Payer: BCBS Complete |
$7.82
|
| Rate for Payer: BCBS Complete |
$39.18
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS Complete |
$21.68
|
| Rate for Payer: BCBS Complete |
$25.43
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$8.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cash Price |
$78.36
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$43.36
|
| Rate for Payer: Cash Price |
$22.30
|
| Rate for Payer: Cash Price |
$22.30
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$78.36
|
| Rate for Payer: Cash Price |
$15.63
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$43.36
|
| Rate for Payer: Cash Price |
$15.63
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cofinity Advantage |
$19.52
|
| Rate for Payer: Cofinity Advantage |
$14.02
|
| Rate for Payer: Cofinity Advantage |
$13.68
|
| Rate for Payer: Cofinity Advantage |
$11.82
|
| Rate for Payer: Cofinity Advantage |
$37.94
|
| Rate for Payer: Cofinity Advantage |
$44.50
|
| Rate for Payer: Cofinity Advantage |
$68.56
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$17.23
|
| Rate for Payer: Cofinity Commercial |
$23.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.36
|
| Rate for Payer: Healthscope Commercial |
$25.09
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Healthscope Commercial |
$88.16
|
| Rate for Payer: Healthscope Commercial |
$48.78
|
| Rate for Payer: Healthscope Commercial |
$17.59
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Healthscope Commercial |
$18.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.66
|
| Rate for Payer: PHP Commercial |
$23.70
|
| Rate for Payer: PHP Commercial |
$17.03
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$16.61
|
| Rate for Payer: PHP Commercial |
$46.07
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: PHP Commercial |
$83.26
|
| Rate for Payer: Priority Health SBD |
$40.05
|
| Rate for Payer: Priority Health SBD |
$12.62
|
| Rate for Payer: Priority Health SBD |
$34.15
|
| Rate for Payer: Priority Health SBD |
$61.71
|
| Rate for Payer: Priority Health SBD |
$12.31
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$17.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UMR Bronson Commercial |
$7.41
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: UMR Bronson Commercial |
$7.23
|
| Rate for Payer: UMR Bronson Commercial |
$6.25
|
| Rate for Payer: UMR Bronson Commercial |
$36.24
|
| Rate for Payer: UMR Bronson Commercial |
$23.52
|
| Rate for Payer: UMR Bronson Commercial |
$20.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.91
|
|
|
NALOXONE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$97.95
|
|
|
Service Code
|
HCPCS J2312
|
| Hospital Charge Code |
5373
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$88.16 |
| Rate for Payer: Aetna American Axle |
$63.67
|
| Rate for Payer: Aetna American Axle |
$41.32
|
| Rate for Payer: Aetna American Axle |
$35.23
|
| Rate for Payer: Aetna American Axle |
$10.97
|
| Rate for Payer: Aetna American Axle |
$18.12
|
| Rate for Payer: Aetna American Axle |
$12.70
|
| Rate for Payer: Aetna Commercial |
$83.26
|
| Rate for Payer: Aetna Commercial |
$23.70
|
| Rate for Payer: Aetna Commercial |
$46.07
|
| Rate for Payer: Aetna Commercial |
$16.61
|
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Cash Price |
$78.36
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$43.36
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$22.30
|
| Rate for Payer: Cash Price |
$15.63
|
| Rate for Payer: Cofinity Advantage |
$37.94
|
| Rate for Payer: Cofinity Advantage |
$13.68
|
| Rate for Payer: Cofinity Advantage |
$11.82
|
| Rate for Payer: Cofinity Advantage |
$44.50
|
| Rate for Payer: Cofinity Advantage |
$19.52
|
| Rate for Payer: Cofinity Advantage |
$68.56
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$84.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.36
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Healthscope Commercial |
$48.78
|
| Rate for Payer: Healthscope Commercial |
$17.59
|
| Rate for Payer: Healthscope Commercial |
$25.09
|
| Rate for Payer: Healthscope Commercial |
$88.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.91
|
| Rate for Payer: PHP Commercial |
$23.70
|
| Rate for Payer: PHP Commercial |
$83.26
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: PHP Commercial |
$46.07
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$16.61
|
| Rate for Payer: Priority Health SBD |
$40.05
|
| Rate for Payer: Priority Health SBD |
$12.31
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$17.56
|
| Rate for Payer: Priority Health SBD |
$34.15
|
| Rate for Payer: Priority Health SBD |
$61.71
|
| Rate for Payer: UMR Bronson Commercial |
$27.97
|
| Rate for Payer: UMR Bronson Commercial |
$12.27
|
| Rate for Payer: UMR Bronson Commercial |
$23.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.60
|
| Rate for Payer: UMR Bronson Commercial |
$43.10
|
| Rate for Payer: UMR Bronson Commercial |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.91
|
|
|
NALOXONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$76.59
|
|
|
Service Code
|
HCPCS J2312
|
| Hospital Charge Code |
5374
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$68.93 |
| Rate for Payer: Aetna American Axle |
$49.78
|
| Rate for Payer: Aetna American Axle |
$26.62
|
| Rate for Payer: Aetna American Axle |
$40.64
|
| Rate for Payer: Aetna American Axle |
$45.67
|
| Rate for Payer: Aetna Commercial |
$65.10
|
| Rate for Payer: Aetna Commercial |
$59.72
|
| Rate for Payer: Aetna Commercial |
$34.81
|
| Rate for Payer: Aetna Commercial |
$53.15
|
| Rate for Payer: Aetna Medicare |
$35.13
|
| Rate for Payer: Aetna Medicare |
$31.27
|
| Rate for Payer: Aetna Medicare |
$38.30
|
| Rate for Payer: Aetna Medicare |
$20.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.67
|
| Rate for Payer: BCBS Complete |
$16.38
|
| Rate for Payer: BCBS Complete |
$25.01
|
| Rate for Payer: BCBS Complete |
$28.10
|
| Rate for Payer: BCBS Complete |
$30.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: Cash Price |
$56.21
|
| Rate for Payer: Cash Price |
$61.27
|
| Rate for Payer: Cash Price |
$32.76
|
| Rate for Payer: Cash Price |
$61.27
|
| Rate for Payer: Cash Price |
$56.21
|
| Rate for Payer: Cash Price |
$50.02
|
| Rate for Payer: Cash Price |
$50.02
|
| Rate for Payer: Cash Price |
$32.76
|
| Rate for Payer: Cofinity Advantage |
$53.61
|
| Rate for Payer: Cofinity Advantage |
$49.18
|
| Rate for Payer: Cofinity Advantage |
$43.77
|
| Rate for Payer: Cofinity Advantage |
$28.66
|
| Rate for Payer: Cofinity Commercial |
$53.78
|
| Rate for Payer: Cofinity Commercial |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$65.87
|
| Rate for Payer: Cofinity Commercial |
$35.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.76
|
| Rate for Payer: Healthscope Commercial |
$63.23
|
| Rate for Payer: Healthscope Commercial |
$36.85
|
| Rate for Payer: Healthscope Commercial |
$56.28
|
| Rate for Payer: Healthscope Commercial |
$68.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.44
|
| Rate for Payer: PHP Commercial |
$34.81
|
| Rate for Payer: PHP Commercial |
$59.72
|
| Rate for Payer: PHP Commercial |
$65.10
|
| Rate for Payer: PHP Commercial |
$53.15
|
| Rate for Payer: Priority Health SBD |
$44.26
|
| Rate for Payer: Priority Health SBD |
$25.80
|
| Rate for Payer: Priority Health SBD |
$39.39
|
| Rate for Payer: Priority Health SBD |
$48.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Core |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.12
|
| Rate for Payer: UMR Bronson Commercial |
$28.34
|
| Rate for Payer: UMR Bronson Commercial |
$15.15
|
| Rate for Payer: UMR Bronson Commercial |
$23.14
|
| Rate for Payer: UMR Bronson Commercial |
$26.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.44
|
|
|
NALOXONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$70.26
|
|
|
Service Code
|
HCPCS J2312
|
| Hospital Charge Code |
5374
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.91 |
| Max. Negotiated Rate |
$63.23 |
| Rate for Payer: Aetna American Axle |
$45.67
|
| Rate for Payer: Aetna American Axle |
$40.64
|
| Rate for Payer: Aetna American Axle |
$49.78
|
| Rate for Payer: Aetna American Axle |
$26.62
|
| Rate for Payer: Aetna Commercial |
$65.10
|
| Rate for Payer: Aetna Commercial |
$59.72
|
| Rate for Payer: Aetna Commercial |
$34.81
|
| Rate for Payer: Aetna Commercial |
$53.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.62
|
| Rate for Payer: Cash Price |
$32.76
|
| Rate for Payer: Cash Price |
$61.27
|
| Rate for Payer: Cash Price |
$50.02
|
| Rate for Payer: Cash Price |
$56.21
|
| Rate for Payer: Cofinity Advantage |
$43.77
|
| Rate for Payer: Cofinity Advantage |
$28.66
|
| Rate for Payer: Cofinity Advantage |
$49.18
|
| Rate for Payer: Cofinity Advantage |
$53.61
|
| Rate for Payer: Cofinity Commercial |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$35.22
|
| Rate for Payer: Cofinity Commercial |
$53.78
|
| Rate for Payer: Cofinity Commercial |
$65.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.02
|
| Rate for Payer: Healthscope Commercial |
$56.28
|
| Rate for Payer: Healthscope Commercial |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$63.23
|
| Rate for Payer: Healthscope Commercial |
$36.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.71
|
| Rate for Payer: PHP Commercial |
$34.81
|
| Rate for Payer: PHP Commercial |
$59.72
|
| Rate for Payer: PHP Commercial |
$53.15
|
| Rate for Payer: PHP Commercial |
$65.10
|
| Rate for Payer: Priority Health SBD |
$48.25
|
| Rate for Payer: Priority Health SBD |
$25.80
|
| Rate for Payer: Priority Health SBD |
$44.26
|
| Rate for Payer: Priority Health SBD |
$39.39
|
| Rate for Payer: UMR Bronson Commercial |
$27.51
|
| Rate for Payer: UMR Bronson Commercial |
$30.91
|
| Rate for Payer: UMR Bronson Commercial |
$18.02
|
| Rate for Payer: UMR Bronson Commercial |
$33.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.44
|
|
|
NALOXONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$95.60
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
180148
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$86.04 |
| Rate for Payer: Aetna American Axle |
$62.14
|
| Rate for Payer: Aetna Commercial |
$81.26
|
| Rate for Payer: Aetna Medicare |
$47.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.14
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: Cash Price |
$76.48
|
| Rate for Payer: Cofinity Advantage |
$66.92
|
| Rate for Payer: Cofinity Commercial |
$82.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.48
|
| Rate for Payer: Healthscope Commercial |
$86.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.70
|
| Rate for Payer: PHP Commercial |
$81.26
|
| Rate for Payer: Priority Health SBD |
$60.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.80
|
| Rate for Payer: UHC Core |
$47.80
|
| Rate for Payer: UHC Exchange |
$47.80
|
| Rate for Payer: UMR Bronson Commercial |
$35.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.70
|
|
|
NALOXONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$95.60
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
180148
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.06 |
| Max. Negotiated Rate |
$86.04 |
| Rate for Payer: Aetna American Axle |
$62.14
|
| Rate for Payer: Aetna Commercial |
$81.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.14
|
| Rate for Payer: Cash Price |
$76.48
|
| Rate for Payer: Cofinity Advantage |
$66.92
|
| Rate for Payer: Cofinity Commercial |
$82.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.48
|
| Rate for Payer: Healthscope Commercial |
$86.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.70
|
| Rate for Payer: PHP Commercial |
$81.26
|
| Rate for Payer: Priority Health SBD |
$60.23
|
| Rate for Payer: UMR Bronson Commercial |
$42.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.70
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
IP
|
$127.59
|
|
|
Service Code
|
NDC 16729008110
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.14 |
| Max. Negotiated Rate |
$114.83 |
| Rate for Payer: Aetna American Axle |
$82.93
|
| Rate for Payer: Aetna Commercial |
$108.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.93
|
| Rate for Payer: Cash Price |
$102.07
|
| Rate for Payer: Cofinity Advantage |
$89.31
|
| Rate for Payer: Cofinity Commercial |
$109.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.07
|
| Rate for Payer: Healthscope Commercial |
$114.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.69
|
| Rate for Payer: PHP Commercial |
$108.45
|
| Rate for Payer: Priority Health SBD |
$80.38
|
| Rate for Payer: UMR Bronson Commercial |
$56.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.69
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
IP
|
$116.50
|
|
|
Service Code
|
NDC 51224020630
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.26 |
| Max. Negotiated Rate |
$104.85 |
| Rate for Payer: Aetna American Axle |
$75.72
|
| Rate for Payer: Aetna Commercial |
$99.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.72
|
| Rate for Payer: Cash Price |
$93.20
|
| Rate for Payer: Cofinity Advantage |
$81.55
|
| Rate for Payer: Cofinity Commercial |
$100.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.20
|
| Rate for Payer: Healthscope Commercial |
$104.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.38
|
| Rate for Payer: PHP Commercial |
$99.03
|
| Rate for Payer: Priority Health SBD |
$73.39
|
| Rate for Payer: UMR Bronson Commercial |
$51.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.38
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
OP
|
$142.28
|
|
|
Service Code
|
NDC 47335032683
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.64 |
| Max. Negotiated Rate |
$128.05 |
| Rate for Payer: Aetna American Axle |
$92.48
|
| Rate for Payer: Aetna Commercial |
$120.94
|
| Rate for Payer: Aetna Medicare |
$71.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.48
|
| Rate for Payer: BCBS Complete |
$56.91
|
| Rate for Payer: Cash Price |
$113.82
|
| Rate for Payer: Cofinity Advantage |
$99.60
|
| Rate for Payer: Cofinity Commercial |
$122.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.82
|
| Rate for Payer: Healthscope Commercial |
$128.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.71
|
| Rate for Payer: PHP Commercial |
$120.94
|
| Rate for Payer: Priority Health SBD |
$89.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.48
|
| Rate for Payer: UHC Core |
$74.13
|
| Rate for Payer: UHC Exchange |
$55.92
|
| Rate for Payer: UMR Bronson Commercial |
$52.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.71
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
OP
|
$127.59
|
|
|
Service Code
|
NDC 16729008110
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.21 |
| Max. Negotiated Rate |
$114.83 |
| Rate for Payer: Aetna American Axle |
$82.93
|
| Rate for Payer: Aetna Commercial |
$108.45
|
| Rate for Payer: Aetna Medicare |
$63.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.93
|
| Rate for Payer: BCBS Complete |
$51.04
|
| Rate for Payer: Cash Price |
$102.07
|
| Rate for Payer: Cofinity Advantage |
$89.31
|
| Rate for Payer: Cofinity Commercial |
$109.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.07
|
| Rate for Payer: Healthscope Commercial |
$114.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.69
|
| Rate for Payer: PHP Commercial |
$108.45
|
| Rate for Payer: Priority Health SBD |
$80.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.93
|
| Rate for Payer: UHC Core |
$66.47
|
| Rate for Payer: UHC Exchange |
$50.14
|
| Rate for Payer: UMR Bronson Commercial |
$47.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.69
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
OP
|
$261.94
|
|
|
Service Code
|
NDC 00406117003
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$235.75 |
| Rate for Payer: Aetna American Axle |
$170.26
|
| Rate for Payer: Aetna Commercial |
$222.65
|
| Rate for Payer: Aetna Medicare |
$130.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.26
|
| Rate for Payer: BCBS Complete |
$104.78
|
| Rate for Payer: Cash Price |
$209.55
|
| Rate for Payer: Cofinity Advantage |
$183.36
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.55
|
| Rate for Payer: Healthscope Commercial |
$235.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.46
|
| Rate for Payer: PHP Commercial |
$222.65
|
| Rate for Payer: Priority Health SBD |
$165.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.26
|
| Rate for Payer: UHC Core |
$136.47
|
| Rate for Payer: UHC Exchange |
$102.94
|
| Rate for Payer: UMR Bronson Commercial |
$96.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.46
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
IP
|
$142.28
|
|
|
Service Code
|
NDC 47335032683
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$128.05 |
| Rate for Payer: Aetna American Axle |
$92.48
|
| Rate for Payer: Aetna Commercial |
$120.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.48
|
| Rate for Payer: Cash Price |
$113.82
|
| Rate for Payer: Cofinity Advantage |
$99.60
|
| Rate for Payer: Cofinity Commercial |
$122.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.82
|
| Rate for Payer: Healthscope Commercial |
$128.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.71
|
| Rate for Payer: PHP Commercial |
$120.94
|
| Rate for Payer: Priority Health SBD |
$89.64
|
| Rate for Payer: UMR Bronson Commercial |
$62.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.71
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
OP
|
$116.50
|
|
|
Service Code
|
NDC 51224020630
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$104.85 |
| Rate for Payer: Aetna American Axle |
$75.72
|
| Rate for Payer: Aetna Commercial |
$99.03
|
| Rate for Payer: Aetna Medicare |
$58.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.72
|
| Rate for Payer: BCBS Complete |
$46.60
|
| Rate for Payer: Cash Price |
$93.20
|
| Rate for Payer: Cofinity Advantage |
$81.55
|
| Rate for Payer: Cofinity Commercial |
$100.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.20
|
| Rate for Payer: Healthscope Commercial |
$104.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.38
|
| Rate for Payer: PHP Commercial |
$99.03
|
| Rate for Payer: Priority Health SBD |
$73.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.72
|
| Rate for Payer: UHC Core |
$60.70
|
| Rate for Payer: UHC Exchange |
$45.78
|
| Rate for Payer: UMR Bronson Commercial |
$43.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.38
|
|
|
NALTREXONE 50 MG TABLET
|
Facility
|
IP
|
$261.94
|
|
|
Service Code
|
NDC 00406117003
|
| Hospital Charge Code |
10685
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.25 |
| Max. Negotiated Rate |
$235.75 |
| Rate for Payer: Aetna American Axle |
$170.26
|
| Rate for Payer: Aetna Commercial |
$222.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.26
|
| Rate for Payer: Cash Price |
$209.55
|
| Rate for Payer: Cofinity Advantage |
$183.36
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.55
|
| Rate for Payer: Healthscope Commercial |
$235.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.46
|
| Rate for Payer: PHP Commercial |
$222.65
|
| Rate for Payer: Priority Health SBD |
$165.02
|
| Rate for Payer: UMR Bronson Commercial |
$115.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.46
|
|
|
NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE
|
Facility
|
IP
|
$6,671.68
|
|
|
Service Code
|
HCPCS J2315
|
| Hospital Charge Code |
76527
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,935.54 |
| Max. Negotiated Rate |
$6,004.51 |
| Rate for Payer: Aetna American Axle |
$4,336.59
|
| Rate for Payer: Aetna Commercial |
$5,670.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,336.59
|
| Rate for Payer: Cash Price |
$5,337.34
|
| Rate for Payer: Cofinity Advantage |
$4,670.18
|
| Rate for Payer: Cofinity Commercial |
$5,737.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,337.34
|
| Rate for Payer: Healthscope Commercial |
$6,004.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,670.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,003.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,670.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,003.76
|
| Rate for Payer: PHP Commercial |
$5,670.93
|
| Rate for Payer: Priority Health SBD |
$4,203.16
|
| Rate for Payer: UMR Bronson Commercial |
$2,935.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,003.76
|
|
|
NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE
|
Facility
|
OP
|
$6,671.68
|
|
|
Service Code
|
HCPCS J2315
|
| Hospital Charge Code |
76527
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$6,004.51 |
| Rate for Payer: Aetna American Axle |
$4,336.59
|
| Rate for Payer: Aetna Commercial |
$5,670.93
|
| Rate for Payer: Aetna Medicare |
$4.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,336.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.31
|
| Rate for Payer: BCBS Complete |
$2.33
|
| Rate for Payer: BCBS MAPPO |
$4.25
|
| Rate for Payer: BCBS Trust/PPO |
$13.75
|
| Rate for Payer: BCN Commercial |
$13.75
|
| Rate for Payer: BCN Medicare Advantage |
$4.25
|
| Rate for Payer: Cash Price |
$5,337.34
|
| Rate for Payer: Cash Price |
$5,337.34
|
| Rate for Payer: Cofinity Advantage |
$4,670.18
|
| Rate for Payer: Cofinity Commercial |
$5,737.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,337.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.25
|
| Rate for Payer: Healthscope Commercial |
$6,004.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,670.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,003.76
|
| Rate for Payer: Mclaren Medicaid |
$4.25
|
| Rate for Payer: Mclaren Medicare |
$4.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.46
|
| Rate for Payer: Meridian Medicaid |
$4.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,670.93
|
| Rate for Payer: Nomi Health Commercial |
$12.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,003.76
|
| Rate for Payer: PACE Medicare |
$4.04
|
| Rate for Payer: PACE SWMI |
$4.25
|
| Rate for Payer: PHP Commercial |
$5,670.93
|
| Rate for Payer: PHP Medicare Advantage |
$4.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.38
|
| Rate for Payer: Priority Health Medicare |
$4.25
|
| Rate for Payer: Priority Health SBD |
$4,203.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.70
|
| Rate for Payer: Railroad Medicare Medicare |
$4.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.00
|
| Rate for Payer: UHC Core |
$7.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.25
|
| Rate for Payer: UHC Exchange |
$7.00
|
| Rate for Payer: UHC Medicaid |
$2.22
|
| Rate for Payer: UHCCP Medicaid |
$2.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,468.52
|
| Rate for Payer: VA VA |
$4.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,003.76
|
|
|
NAPHAZOLINE-PHENIRAMINE 0.02675 %-0.315 % EYE DROPS
|
Facility
|
OP
|
$25.68
|
|
|
Service Code
|
NDC 10119002090
|
| Hospital Charge Code |
15058
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$23.11 |
| Rate for Payer: Aetna American Axle |
$16.69
|
| Rate for Payer: Aetna Commercial |
$21.83
|
| Rate for Payer: Aetna Medicare |
$12.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.69
|
| Rate for Payer: BCBS Complete |
$10.27
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Advantage |
$17.98
|
| Rate for Payer: Cofinity Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Healthscope Commercial |
$23.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.26
|
| Rate for Payer: PHP Commercial |
$21.83
|
| Rate for Payer: Priority Health SBD |
$16.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.69
|
| Rate for Payer: UHC Core |
$13.38
|
| Rate for Payer: UHC Exchange |
$10.09
|
| Rate for Payer: UMR Bronson Commercial |
$9.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.26
|
|
|
NAPHAZOLINE-PHENIRAMINE 0.02675 %-0.315 % EYE DROPS
|
Facility
|
IP
|
$25.68
|
|
|
Service Code
|
NDC 10119002090
|
| Hospital Charge Code |
15058
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$23.11 |
| Rate for Payer: Aetna American Axle |
$16.69
|
| Rate for Payer: Aetna Commercial |
$21.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.69
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Advantage |
$17.98
|
| Rate for Payer: Cofinity Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Healthscope Commercial |
$23.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.26
|
| Rate for Payer: PHP Commercial |
$21.83
|
| Rate for Payer: Priority Health SBD |
$16.18
|
| Rate for Payer: UMR Bronson Commercial |
$11.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.26
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$2,189.76
|
|
|
Service Code
|
NDC 42192061916
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$810.21 |
| Max. Negotiated Rate |
$1,970.78 |
| Rate for Payer: Aetna American Axle |
$1,423.34
|
| Rate for Payer: Aetna Commercial |
$1,861.30
|
| Rate for Payer: Aetna Medicare |
$1,094.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.34
|
| Rate for Payer: BCBS Complete |
$875.90
|
| Rate for Payer: Cash Price |
$1,751.81
|
| Rate for Payer: Cofinity Advantage |
$1,532.83
|
| Rate for Payer: Cofinity Commercial |
$1,883.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.81
|
| Rate for Payer: Healthscope Commercial |
$1,970.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,532.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,642.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,751.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.32
|
| Rate for Payer: PHP Commercial |
$1,861.30
|
| Rate for Payer: Priority Health SBD |
$1,379.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,423.34
|
| Rate for Payer: UHC Core |
$1,140.86
|
| Rate for Payer: UHC Exchange |
$860.58
|
| Rate for Payer: UMR Bronson Commercial |
$810.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,642.32
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$3,606.96
|
|
|
Service Code
|
NDC 71511070116
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,587.06 |
| Max. Negotiated Rate |
$3,246.26 |
| Rate for Payer: Aetna American Axle |
$2,344.52
|
| Rate for Payer: Aetna Commercial |
$3,065.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.52
|
| Rate for Payer: Cash Price |
$2,885.57
|
| Rate for Payer: Cofinity Advantage |
$2,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,101.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.57
|
| Rate for Payer: Healthscope Commercial |
$3,246.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,524.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,705.22
|
| Rate for Payer: PHP Commercial |
$3,065.92
|
| Rate for Payer: Priority Health SBD |
$2,272.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,587.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.22
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$2,088.00
|
|
|
Service Code
|
NDC 68134020116
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$918.72 |
| Max. Negotiated Rate |
$1,879.20 |
| Rate for Payer: Aetna American Axle |
$1,357.20
|
| Rate for Payer: Aetna Commercial |
$1,774.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,357.20
|
| Rate for Payer: Cash Price |
$1,670.40
|
| Rate for Payer: Cofinity Advantage |
$1,461.60
|
| Rate for Payer: Cofinity Commercial |
$1,795.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.40
|
| Rate for Payer: Healthscope Commercial |
$1,879.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,461.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,566.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,566.00
|
| Rate for Payer: PHP Commercial |
$1,774.80
|
| Rate for Payer: Priority Health SBD |
$1,315.44
|
| Rate for Payer: UMR Bronson Commercial |
$918.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,566.00
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$2,088.00
|
|
|
Service Code
|
NDC 68134020116
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$772.56 |
| Max. Negotiated Rate |
$1,879.20 |
| Rate for Payer: Aetna American Axle |
$1,357.20
|
| Rate for Payer: Aetna Commercial |
$1,774.80
|
| Rate for Payer: Aetna Medicare |
$1,044.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,357.20
|
| Rate for Payer: BCBS Complete |
$835.20
|
| Rate for Payer: Cash Price |
$1,670.40
|
| Rate for Payer: Cofinity Advantage |
$1,461.60
|
| Rate for Payer: Cofinity Commercial |
$1,795.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,670.40
|
| Rate for Payer: Healthscope Commercial |
$1,879.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,461.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,566.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,670.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,566.00
|
| Rate for Payer: PHP Commercial |
$1,774.80
|
| Rate for Payer: Priority Health SBD |
$1,315.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.20
|
| Rate for Payer: UHC Core |
$1,087.85
|
| Rate for Payer: UHC Exchange |
$820.58
|
| Rate for Payer: UMR Bronson Commercial |
$772.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,566.00
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,562.04
|
|
|
Service Code
|
NDC 69238173002
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$687.30 |
| Max. Negotiated Rate |
$1,405.84 |
| Rate for Payer: Aetna American Axle |
$1,015.33
|
| Rate for Payer: Aetna Commercial |
$1,327.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.33
|
| Rate for Payer: Cash Price |
$1,249.63
|
| Rate for Payer: Cofinity Advantage |
$1,093.43
|
| Rate for Payer: Cofinity Commercial |
$1,343.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.63
|
| Rate for Payer: Healthscope Commercial |
$1,405.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,093.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,171.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.53
|
| Rate for Payer: PHP Commercial |
$1,327.73
|
| Rate for Payer: Priority Health SBD |
$984.09
|
| Rate for Payer: UMR Bronson Commercial |
$687.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,171.53
|
|
|
NAPROXEN 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$3,606.96
|
|
|
Service Code
|
NDC 71511070116
|
| Hospital Charge Code |
10691
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,334.58 |
| Max. Negotiated Rate |
$3,246.26 |
| Rate for Payer: Aetna American Axle |
$2,344.52
|
| Rate for Payer: Aetna Commercial |
$3,065.92
|
| Rate for Payer: Aetna Medicare |
$1,803.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.52
|
| Rate for Payer: BCBS Complete |
$1,442.78
|
| Rate for Payer: Cash Price |
$2,885.57
|
| Rate for Payer: Cofinity Advantage |
$2,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,101.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.57
|
| Rate for Payer: Healthscope Commercial |
$3,246.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,524.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,885.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,705.22
|
| Rate for Payer: PHP Commercial |
$3,065.92
|
| Rate for Payer: Priority Health SBD |
$2,272.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,344.52
|
| Rate for Payer: UHC Core |
$1,879.23
|
| Rate for Payer: UHC Exchange |
$1,417.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,334.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.22
|
|
