|
NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$676.23
|
|
|
Service Code
|
NDC 65862005724
|
| Hospital Charge Code |
24119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$297.54 |
| Max. Negotiated Rate |
$608.61 |
| Rate for Payer: Aetna American Axle |
$439.55
|
| Rate for Payer: Aetna Commercial |
$574.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.55
|
| Rate for Payer: Cash Price |
$540.98
|
| Rate for Payer: Cofinity Commercial |
$473.36
|
| Rate for Payer: Cofinity Commercial |
$581.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$473.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.98
|
| Rate for Payer: Healthscope Commercial |
$608.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.80
|
| Rate for Payer: PHP Commercial |
$574.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.55
|
| Rate for Payer: Priority Health SBD |
$426.02
|
| Rate for Payer: UMR Bronson Commercial |
$297.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.17
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$3,031.41
|
|
|
Service Code
|
NDC 00597012330
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,121.62 |
| Max. Negotiated Rate |
$2,728.27 |
| Rate for Payer: Aetna American Axle |
$1,970.42
|
| Rate for Payer: Aetna Commercial |
$2,576.70
|
| Rate for Payer: Aetna Medicare |
$1,515.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,970.42
|
| Rate for Payer: BCBS Complete |
$1,212.56
|
| Rate for Payer: Cash Price |
$2,425.13
|
| Rate for Payer: Cofinity Commercial |
$2,121.99
|
| Rate for Payer: Cofinity Commercial |
$2,607.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,121.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,425.13
|
| Rate for Payer: Healthscope Commercial |
$2,728.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,121.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,273.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,576.70
|
| Rate for Payer: PHP Commercial |
$2,576.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,970.42
|
| Rate for Payer: Priority Health SBD |
$1,909.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,121.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,273.56
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$266.74
|
|
|
Service Code
|
NDC 33342023807
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$240.07 |
| Rate for Payer: Aetna American Axle |
$173.38
|
| Rate for Payer: Aetna Commercial |
$226.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.38
|
| Rate for Payer: Cash Price |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$186.72
|
| Rate for Payer: Cofinity Commercial |
$229.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.39
|
| Rate for Payer: Healthscope Commercial |
$240.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.73
|
| Rate for Payer: PHP Commercial |
$226.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.38
|
| Rate for Payer: Priority Health SBD |
$168.05
|
| Rate for Payer: UMR Bronson Commercial |
$117.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.06
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$3,031.41
|
|
|
Service Code
|
NDC 00597012330
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,333.82 |
| Max. Negotiated Rate |
$2,728.27 |
| Rate for Payer: Aetna American Axle |
$1,970.42
|
| Rate for Payer: Aetna Commercial |
$2,576.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,970.42
|
| Rate for Payer: Cash Price |
$2,425.13
|
| Rate for Payer: Cofinity Commercial |
$2,121.99
|
| Rate for Payer: Cofinity Commercial |
$2,607.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,121.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,425.13
|
| Rate for Payer: Healthscope Commercial |
$2,728.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,121.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,273.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,576.70
|
| Rate for Payer: PHP Commercial |
$2,576.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,970.42
|
| Rate for Payer: Priority Health SBD |
$1,909.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,333.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,273.56
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$266.74
|
|
|
Service Code
|
NDC 33342023807
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.69 |
| Max. Negotiated Rate |
$240.07 |
| Rate for Payer: Aetna American Axle |
$173.38
|
| Rate for Payer: Aetna Commercial |
$226.73
|
| Rate for Payer: Aetna Medicare |
$133.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.38
|
| Rate for Payer: BCBS Complete |
$106.70
|
| Rate for Payer: Cash Price |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$186.72
|
| Rate for Payer: Cofinity Commercial |
$229.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.39
|
| Rate for Payer: Healthscope Commercial |
$240.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.73
|
| Rate for Payer: PHP Commercial |
$226.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.38
|
| Rate for Payer: Priority Health SBD |
$168.05
|
| Rate for Payer: UMR Bronson Commercial |
$98.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.06
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,849.38
|
|
|
Service Code
|
NDC 47781031730
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$813.73 |
| Max. Negotiated Rate |
$1,664.44 |
| Rate for Payer: Aetna American Axle |
$1,202.10
|
| Rate for Payer: Aetna Commercial |
$1,571.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.10
|
| Rate for Payer: Cash Price |
$1,479.50
|
| Rate for Payer: Cofinity Commercial |
$1,294.57
|
| Rate for Payer: Cofinity Commercial |
$1,590.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,294.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,479.50
|
| Rate for Payer: Healthscope Commercial |
$1,664.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,294.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,387.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,571.97
|
| Rate for Payer: PHP Commercial |
$1,571.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,202.10
|
| Rate for Payer: Priority Health SBD |
$1,165.11
|
| Rate for Payer: UMR Bronson Commercial |
$813.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,387.04
|
|
|
NEVIRAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,849.38
|
|
|
Service Code
|
NDC 47781031730
|
| Hospital Charge Code |
152490
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$684.27 |
| Max. Negotiated Rate |
$1,664.44 |
| Rate for Payer: Aetna American Axle |
$1,202.10
|
| Rate for Payer: Aetna Commercial |
$1,571.97
|
| Rate for Payer: Aetna Medicare |
$924.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.10
|
| Rate for Payer: BCBS Complete |
$739.75
|
| Rate for Payer: Cash Price |
$1,479.50
|
| Rate for Payer: Cofinity Commercial |
$1,294.57
|
| Rate for Payer: Cofinity Commercial |
$1,590.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,294.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,479.50
|
| Rate for Payer: Healthscope Commercial |
$1,664.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,294.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,387.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,571.97
|
| Rate for Payer: PHP Commercial |
$1,571.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,202.10
|
| Rate for Payer: Priority Health SBD |
$1,165.11
|
| Rate for Payer: UMR Bronson Commercial |
$684.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,387.04
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$283.01
|
|
|
Service Code
|
NDC 59651001890
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.71 |
| Max. Negotiated Rate |
$254.71 |
| Rate for Payer: Aetna American Axle |
$183.96
|
| Rate for Payer: Aetna Commercial |
$240.56
|
| Rate for Payer: Aetna Medicare |
$141.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.96
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: Cash Price |
$226.41
|
| Rate for Payer: Cofinity Commercial |
$198.11
|
| Rate for Payer: Cofinity Commercial |
$243.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.41
|
| Rate for Payer: Healthscope Commercial |
$254.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.56
|
| Rate for Payer: PHP Commercial |
$240.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.96
|
| Rate for Payer: Priority Health SBD |
$178.30
|
| Rate for Payer: UMR Bronson Commercial |
$104.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.26
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$283.01
|
|
|
Service Code
|
NDC 59651001890
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.52 |
| Max. Negotiated Rate |
$254.71 |
| Rate for Payer: Aetna American Axle |
$183.96
|
| Rate for Payer: Aetna Commercial |
$240.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.96
|
| Rate for Payer: Cash Price |
$226.41
|
| Rate for Payer: Cofinity Commercial |
$198.11
|
| Rate for Payer: Cofinity Commercial |
$243.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.41
|
| Rate for Payer: Healthscope Commercial |
$254.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.56
|
| Rate for Payer: PHP Commercial |
$240.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.96
|
| Rate for Payer: Priority Health SBD |
$178.30
|
| Rate for Payer: UMR Bronson Commercial |
$124.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.26
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$234.27
|
|
|
Service Code
|
NDC 65162032109
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$210.84 |
| Rate for Payer: Aetna American Axle |
$152.28
|
| Rate for Payer: Aetna Commercial |
$199.13
|
| Rate for Payer: Aetna Medicare |
$117.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.28
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: Cash Price |
$187.42
|
| Rate for Payer: Cofinity Commercial |
$163.99
|
| Rate for Payer: Cofinity Commercial |
$201.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.42
|
| Rate for Payer: Healthscope Commercial |
$210.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.13
|
| Rate for Payer: PHP Commercial |
$199.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.28
|
| Rate for Payer: Priority Health SBD |
$147.59
|
| Rate for Payer: UMR Bronson Commercial |
$86.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.70
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$234.27
|
|
|
Service Code
|
NDC 65162032109
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$103.08 |
| Max. Negotiated Rate |
$210.84 |
| Rate for Payer: Aetna American Axle |
$152.28
|
| Rate for Payer: Aetna Commercial |
$199.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.28
|
| Rate for Payer: Cash Price |
$187.42
|
| Rate for Payer: Cofinity Commercial |
$163.99
|
| Rate for Payer: Cofinity Commercial |
$201.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.42
|
| Rate for Payer: Healthscope Commercial |
$210.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.13
|
| Rate for Payer: PHP Commercial |
$199.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.28
|
| Rate for Payer: Priority Health SBD |
$147.59
|
| Rate for Payer: UMR Bronson Commercial |
$103.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.70
|
|
|
NICARDIPINE 10 MG/500 ML NS
|
Facility
|
IP
|
$1,860.80
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
151055
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$818.75 |
| Max. Negotiated Rate |
$1,674.72 |
| Rate for Payer: Aetna American Axle |
$1,209.52
|
| Rate for Payer: Aetna Commercial |
$1,581.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.52
|
| Rate for Payer: Cash Price |
$1,488.64
|
| Rate for Payer: Cofinity Commercial |
$1,302.56
|
| Rate for Payer: Cofinity Commercial |
$1,600.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.64
|
| Rate for Payer: Healthscope Commercial |
$1,674.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,302.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.68
|
| Rate for Payer: PHP Commercial |
$1,581.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.52
|
| Rate for Payer: Priority Health SBD |
$1,172.30
|
| Rate for Payer: UMR Bronson Commercial |
$818.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.60
|
|
|
NICARDIPINE 10 MG/500 ML NS
|
Facility
|
OP
|
$1,860.80
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
151055
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$688.50 |
| Max. Negotiated Rate |
$1,674.72 |
| Rate for Payer: Aetna American Axle |
$1,209.52
|
| Rate for Payer: Aetna Commercial |
$1,581.68
|
| Rate for Payer: Aetna Medicare |
$930.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.52
|
| Rate for Payer: BCBS Complete |
$744.32
|
| Rate for Payer: Cash Price |
$1,488.64
|
| Rate for Payer: Cofinity Commercial |
$1,302.56
|
| Rate for Payer: Cofinity Commercial |
$1,600.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.64
|
| Rate for Payer: Healthscope Commercial |
$1,674.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,302.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.68
|
| Rate for Payer: PHP Commercial |
$1,581.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.52
|
| Rate for Payer: Priority Health SBD |
$1,172.30
|
| Rate for Payer: UMR Bronson Commercial |
$688.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.60
|
|
|
NICARDIPINE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN
|
Facility
|
IP
|
$201.38
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
94219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.61 |
| Max. Negotiated Rate |
$181.24 |
| Rate for Payer: Aetna American Axle |
$130.90
|
| Rate for Payer: Aetna Commercial |
$171.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.90
|
| Rate for Payer: Cash Price |
$161.10
|
| Rate for Payer: Cofinity Commercial |
$140.97
|
| Rate for Payer: Cofinity Commercial |
$173.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.10
|
| Rate for Payer: Healthscope Commercial |
$181.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.17
|
| Rate for Payer: PHP Commercial |
$171.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health SBD |
$126.87
|
| Rate for Payer: UMR Bronson Commercial |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.03
|
|
|
NICARDIPINE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN
|
Facility
|
OP
|
$201.38
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
94219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.51 |
| Max. Negotiated Rate |
$181.24 |
| Rate for Payer: Aetna American Axle |
$130.90
|
| Rate for Payer: Aetna Commercial |
$171.17
|
| Rate for Payer: Aetna Medicare |
$100.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.90
|
| Rate for Payer: BCBS Complete |
$80.55
|
| Rate for Payer: Cash Price |
$161.10
|
| Rate for Payer: Cofinity Commercial |
$140.97
|
| Rate for Payer: Cofinity Commercial |
$173.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.10
|
| Rate for Payer: Healthscope Commercial |
$181.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.17
|
| Rate for Payer: PHP Commercial |
$171.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health SBD |
$126.87
|
| Rate for Payer: UMR Bronson Commercial |
$74.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.03
|
|
|
NICARDIPINE 20 MG CAPSULE
|
Facility
|
IP
|
$714.96
|
|
|
Service Code
|
NDC 00378102077
|
| Hospital Charge Code |
10712
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$643.46 |
| Rate for Payer: Aetna American Axle |
$464.72
|
| Rate for Payer: Aetna Commercial |
$607.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.72
|
| Rate for Payer: Cash Price |
$571.97
|
| Rate for Payer: Cofinity Commercial |
$500.47
|
| Rate for Payer: Cofinity Commercial |
$614.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$500.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.97
|
| Rate for Payer: Healthscope Commercial |
$643.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.72
|
| Rate for Payer: PHP Commercial |
$607.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.72
|
| Rate for Payer: Priority Health SBD |
$450.42
|
| Rate for Payer: UMR Bronson Commercial |
$314.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.22
|
|
|
NICARDIPINE 20 MG CAPSULE
|
Facility
|
IP
|
$707.96
|
|
|
Service Code
|
NDC 42806050109
|
| Hospital Charge Code |
10712
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$311.50 |
| Max. Negotiated Rate |
$637.16 |
| Rate for Payer: Aetna American Axle |
$460.17
|
| Rate for Payer: Aetna Commercial |
$601.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.17
|
| Rate for Payer: Cash Price |
$566.37
|
| Rate for Payer: Cofinity Commercial |
$495.57
|
| Rate for Payer: Cofinity Commercial |
$608.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$495.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$566.37
|
| Rate for Payer: Healthscope Commercial |
$637.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.77
|
| Rate for Payer: PHP Commercial |
$601.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.17
|
| Rate for Payer: Priority Health SBD |
$446.01
|
| Rate for Payer: UMR Bronson Commercial |
$311.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.97
|
|
|
NICARDIPINE 20 MG CAPSULE
|
Facility
|
OP
|
$707.96
|
|
|
Service Code
|
NDC 42806050109
|
| Hospital Charge Code |
10712
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$261.95 |
| Max. Negotiated Rate |
$637.16 |
| Rate for Payer: Aetna American Axle |
$460.17
|
| Rate for Payer: Aetna Commercial |
$601.77
|
| Rate for Payer: Aetna Medicare |
$353.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.17
|
| Rate for Payer: BCBS Complete |
$283.18
|
| Rate for Payer: Cash Price |
$566.37
|
| Rate for Payer: Cofinity Commercial |
$495.57
|
| Rate for Payer: Cofinity Commercial |
$608.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$495.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$566.37
|
| Rate for Payer: Healthscope Commercial |
$637.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.77
|
| Rate for Payer: PHP Commercial |
$601.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.17
|
| Rate for Payer: Priority Health SBD |
$446.01
|
| Rate for Payer: UMR Bronson Commercial |
$261.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.97
|
|
|
NICARDIPINE 20 MG CAPSULE
|
Facility
|
OP
|
$714.96
|
|
|
Service Code
|
NDC 00378102077
|
| Hospital Charge Code |
10712
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$264.54 |
| Max. Negotiated Rate |
$643.46 |
| Rate for Payer: Aetna American Axle |
$464.72
|
| Rate for Payer: Aetna Commercial |
$607.72
|
| Rate for Payer: Aetna Medicare |
$357.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.72
|
| Rate for Payer: BCBS Complete |
$285.98
|
| Rate for Payer: Cash Price |
$571.97
|
| Rate for Payer: Cofinity Commercial |
$500.47
|
| Rate for Payer: Cofinity Commercial |
$614.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$500.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.97
|
| Rate for Payer: Healthscope Commercial |
$643.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.72
|
| Rate for Payer: PHP Commercial |
$607.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.72
|
| Rate for Payer: Priority Health SBD |
$450.42
|
| Rate for Payer: UMR Bronson Commercial |
$264.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.22
|
|
|
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$48.20
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
12370
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.21 |
| Max. Negotiated Rate |
$43.38 |
| Rate for Payer: Aetna American Axle |
$31.33
|
| Rate for Payer: Aetna American Axle |
$61.73
|
| Rate for Payer: Aetna American Axle |
$33.64
|
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna American Axle |
$97.02
|
| Rate for Payer: Aetna Commercial |
$80.72
|
| Rate for Payer: Aetna Commercial |
$44.00
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.33
|
| Rate for Payer: Cash Price |
$38.56
|
| Rate for Payer: Cash Price |
$119.41
|
| Rate for Payer: Cash Price |
$75.98
|
| Rate for Payer: Cash Price |
$41.41
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Commercial |
$81.67
|
| Rate for Payer: Cofinity Commercial |
$128.36
|
| Rate for Payer: Cofinity Commercial |
$104.48
|
| Rate for Payer: Cofinity Commercial |
$26.07
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$41.45
|
| Rate for Payer: Cofinity Commercial |
$66.48
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$43.38
|
| Rate for Payer: Healthscope Commercial |
$134.33
|
| Rate for Payer: Healthscope Commercial |
$85.47
|
| Rate for Payer: Healthscope Commercial |
$46.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$40.97
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$80.72
|
| Rate for Payer: PHP Commercial |
$44.00
|
| Rate for Payer: PHP Commercial |
$126.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.64
|
| Rate for Payer: Priority Health SBD |
$30.37
|
| Rate for Payer: Priority Health SBD |
$32.61
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$94.03
|
| Rate for Payer: Priority Health SBD |
$59.83
|
| Rate for Payer: UMR Bronson Commercial |
$41.79
|
| Rate for Payer: UMR Bronson Commercial |
$22.77
|
| Rate for Payer: UMR Bronson Commercial |
$21.21
|
| Rate for Payer: UMR Bronson Commercial |
$65.67
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.15
|
|
|
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$37.25
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
12370
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.78 |
| Max. Negotiated Rate |
$33.52 |
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna American Axle |
$33.64
|
| Rate for Payer: Aetna American Axle |
$61.73
|
| Rate for Payer: Aetna American Axle |
$97.02
|
| Rate for Payer: Aetna American Axle |
$31.33
|
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: Aetna Commercial |
$80.72
|
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Commercial |
$44.00
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Medicare |
$25.88
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna Medicare |
$47.48
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Aetna Medicare |
$74.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.64
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS Complete |
$59.70
|
| Rate for Payer: BCBS Complete |
$20.70
|
| Rate for Payer: BCBS Complete |
$19.28
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: Cash Price |
$75.98
|
| Rate for Payer: Cash Price |
$119.41
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$41.41
|
| Rate for Payer: Cash Price |
$38.56
|
| Rate for Payer: Cofinity Commercial |
$66.48
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Cofinity Commercial |
$104.48
|
| Rate for Payer: Cofinity Commercial |
$41.45
|
| Rate for Payer: Cofinity Commercial |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$36.23
|
| Rate for Payer: Cofinity Commercial |
$128.36
|
| Rate for Payer: Cofinity Commercial |
$26.07
|
| Rate for Payer: Cofinity Commercial |
$81.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.56
|
| Rate for Payer: Healthscope Commercial |
$134.33
|
| Rate for Payer: Healthscope Commercial |
$43.38
|
| Rate for Payer: Healthscope Commercial |
$85.47
|
| Rate for Payer: Healthscope Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.72
|
| Rate for Payer: PHP Commercial |
$44.00
|
| Rate for Payer: PHP Commercial |
$40.97
|
| Rate for Payer: PHP Commercial |
$126.87
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$80.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$94.03
|
| Rate for Payer: Priority Health SBD |
$30.37
|
| Rate for Payer: Priority Health SBD |
$32.61
|
| Rate for Payer: Priority Health SBD |
$59.83
|
| Rate for Payer: UMR Bronson Commercial |
$35.14
|
| Rate for Payer: UMR Bronson Commercial |
$19.15
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$55.23
|
| Rate for Payer: UMR Bronson Commercial |
$17.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.15
|
|
|
NICARDIPINE 30 MG CAPSULE
|
Facility
|
IP
|
$1,129.87
|
|
|
Service Code
|
NDC 42806050209
|
| Hospital Charge Code |
10713
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$497.14 |
| Max. Negotiated Rate |
$1,016.88 |
| Rate for Payer: Aetna American Axle |
$734.42
|
| Rate for Payer: Aetna Commercial |
$960.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.42
|
| Rate for Payer: Cash Price |
$903.90
|
| Rate for Payer: Cofinity Commercial |
$790.91
|
| Rate for Payer: Cofinity Commercial |
$971.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.90
|
| Rate for Payer: Healthscope Commercial |
$1,016.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$790.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$847.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$960.39
|
| Rate for Payer: PHP Commercial |
$960.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$734.42
|
| Rate for Payer: Priority Health SBD |
$711.82
|
| Rate for Payer: UMR Bronson Commercial |
$497.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$847.40
|
|
|
NICARDIPINE 30 MG CAPSULE
|
Facility
|
OP
|
$789.55
|
|
|
Service Code
|
NDC 00378143077
|
| Hospital Charge Code |
10713
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$292.13 |
| Max. Negotiated Rate |
$710.60 |
| Rate for Payer: Aetna American Axle |
$513.21
|
| Rate for Payer: Aetna Commercial |
$671.12
|
| Rate for Payer: Aetna Medicare |
$394.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.21
|
| Rate for Payer: BCBS Complete |
$315.82
|
| Rate for Payer: Cash Price |
$631.64
|
| Rate for Payer: Cofinity Commercial |
$552.68
|
| Rate for Payer: Cofinity Commercial |
$679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.64
|
| Rate for Payer: Healthscope Commercial |
$710.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.12
|
| Rate for Payer: PHP Commercial |
$671.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.21
|
| Rate for Payer: Priority Health SBD |
$497.42
|
| Rate for Payer: UMR Bronson Commercial |
$292.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.16
|
|
|
NICARDIPINE 30 MG CAPSULE
|
Facility
|
OP
|
$1,129.87
|
|
|
Service Code
|
NDC 42806050209
|
| Hospital Charge Code |
10713
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$418.05 |
| Max. Negotiated Rate |
$1,016.88 |
| Rate for Payer: Aetna American Axle |
$734.42
|
| Rate for Payer: Aetna Commercial |
$960.39
|
| Rate for Payer: Aetna Medicare |
$564.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.42
|
| Rate for Payer: BCBS Complete |
$451.95
|
| Rate for Payer: Cash Price |
$903.90
|
| Rate for Payer: Cofinity Commercial |
$790.91
|
| Rate for Payer: Cofinity Commercial |
$971.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.90
|
| Rate for Payer: Healthscope Commercial |
$1,016.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$790.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$847.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$960.39
|
| Rate for Payer: PHP Commercial |
$960.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$734.42
|
| Rate for Payer: Priority Health SBD |
$711.82
|
| Rate for Payer: UMR Bronson Commercial |
$418.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$847.40
|
|
|
NICARDIPINE 30 MG CAPSULE
|
Facility
|
IP
|
$789.55
|
|
|
Service Code
|
NDC 00378143077
|
| Hospital Charge Code |
10713
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$710.60 |
| Rate for Payer: Aetna American Axle |
$513.21
|
| Rate for Payer: Aetna Commercial |
$671.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.21
|
| Rate for Payer: Cash Price |
$631.64
|
| Rate for Payer: Cofinity Commercial |
$552.68
|
| Rate for Payer: Cofinity Commercial |
$679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.64
|
| Rate for Payer: Healthscope Commercial |
$710.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.12
|
| Rate for Payer: PHP Commercial |
$671.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.21
|
| Rate for Payer: Priority Health SBD |
$497.42
|
| Rate for Payer: UMR Bronson Commercial |
$347.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.16
|
|
