|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.78
|
|
|
Service Code
|
NDC 63323094021
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.69 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Aetna American Axle |
$13.51
|
| Rate for Payer: Aetna Commercial |
$17.66
|
| Rate for Payer: Aetna Medicare |
$10.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.51
|
| Rate for Payer: BCBS Complete |
$8.31
|
| Rate for Payer: Cash Price |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.55
|
| Rate for Payer: Cofinity Commercial |
$17.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$18.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.66
|
| Rate for Payer: PHP Commercial |
$17.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health SBD |
$13.09
|
| Rate for Payer: UMR Bronson Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.58
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$36.17
|
|
|
Service Code
|
NDC 47335061544
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$32.55 |
| Rate for Payer: Aetna American Axle |
$23.51
|
| Rate for Payer: Aetna Commercial |
$30.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.51
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$25.32
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$32.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: PHP Commercial |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.51
|
| Rate for Payer: Priority Health SBD |
$22.79
|
| Rate for Payer: UMR Bronson Commercial |
$15.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.13
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.25
|
|
|
Service Code
|
NDC 36000016201
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$18.22 |
| Rate for Payer: Aetna American Axle |
$13.16
|
| Rate for Payer: Aetna Commercial |
$17.21
|
| Rate for Payer: Aetna Medicare |
$10.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.16
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cofinity Commercial |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.20
|
| Rate for Payer: Healthscope Commercial |
$18.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.21
|
| Rate for Payer: PHP Commercial |
$17.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.16
|
| Rate for Payer: Priority Health SBD |
$12.76
|
| Rate for Payer: UMR Bronson Commercial |
$7.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.78
|
|
|
Service Code
|
NDC 63323094021
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Aetna American Axle |
$13.51
|
| Rate for Payer: Aetna Commercial |
$17.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.51
|
| Rate for Payer: Cash Price |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.55
|
| Rate for Payer: Cofinity Commercial |
$17.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$18.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.66
|
| Rate for Payer: PHP Commercial |
$17.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health SBD |
$13.09
|
| Rate for Payer: UMR Bronson Commercial |
$9.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.58
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.67
|
|
|
Service Code
|
NDC 71839014301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna American Axle |
$14.09
|
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna Medicare |
$10.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.09
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$15.17
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.09
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.59
|
|
|
Service Code
|
NDC 00703115301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna American Axle |
$48.48
|
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.48
|
| Rate for Payer: BCBS Complete |
$29.84
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$52.21
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.48
|
| Rate for Payer: Priority Health SBD |
$46.99
|
| Rate for Payer: UMR Bronson Commercial |
$27.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.59
|
|
|
Service Code
|
NDC 00409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna American Axle |
$15.33
|
| Rate for Payer: Aetna Commercial |
$20.05
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.33
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: Cash Price |
$18.87
|
| Rate for Payer: Cofinity Commercial |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$21.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.05
|
| Rate for Payer: PHP Commercial |
$20.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.33
|
| Rate for Payer: Priority Health SBD |
$14.86
|
| Rate for Payer: UMR Bronson Commercial |
$8.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.69
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$36.17
|
|
|
Service Code
|
NDC 47335061544
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$32.55 |
| Rate for Payer: Aetna American Axle |
$23.51
|
| Rate for Payer: Aetna Commercial |
$30.74
|
| Rate for Payer: Aetna Medicare |
$18.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.51
|
| Rate for Payer: BCBS Complete |
$14.47
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$25.32
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$32.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: PHP Commercial |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.51
|
| Rate for Payer: Priority Health SBD |
$22.79
|
| Rate for Payer: UMR Bronson Commercial |
$13.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.13
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.67
|
|
|
Service Code
|
NDC 71839014325
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna American Axle |
$14.09
|
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.09
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$15.17
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.09
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$9.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.59
|
|
|
Service Code
|
NDC 00409337514
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna American Axle |
$15.33
|
| Rate for Payer: Aetna Commercial |
$20.05
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.33
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: Cash Price |
$18.87
|
| Rate for Payer: Cofinity Commercial |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$21.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.05
|
| Rate for Payer: PHP Commercial |
$20.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.33
|
| Rate for Payer: Priority Health SBD |
$14.86
|
| Rate for Payer: UMR Bronson Commercial |
$8.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.69
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.46
|
|
|
Service Code
|
NDC 00143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$22.91 |
| Rate for Payer: Aetna American Axle |
$16.55
|
| Rate for Payer: Aetna Commercial |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.55
|
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Cofinity Commercial |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.37
|
| Rate for Payer: Healthscope Commercial |
$22.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.64
|
| Rate for Payer: PHP Commercial |
$21.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.55
|
| Rate for Payer: Priority Health SBD |
$16.04
|
| Rate for Payer: UMR Bronson Commercial |
$11.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.25
|
|
|
Service Code
|
NDC 36000016210
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$18.22 |
| Rate for Payer: Aetna American Axle |
$13.16
|
| Rate for Payer: Aetna Commercial |
$17.21
|
| Rate for Payer: Aetna Medicare |
$10.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.16
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cofinity Commercial |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.20
|
| Rate for Payer: Healthscope Commercial |
$18.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.21
|
| Rate for Payer: PHP Commercial |
$17.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.16
|
| Rate for Payer: Priority Health SBD |
$12.76
|
| Rate for Payer: UMR Bronson Commercial |
$7.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.19
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.59
|
|
|
Service Code
|
NDC 00703115301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.82 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna American Axle |
$48.48
|
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.48
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$52.21
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.48
|
| Rate for Payer: Priority Health SBD |
$46.99
|
| Rate for Payer: UMR Bronson Commercial |
$32.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.46
|
|
|
Service Code
|
NDC 00143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$22.91 |
| Rate for Payer: Aetna American Axle |
$16.55
|
| Rate for Payer: Aetna Commercial |
$21.64
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.55
|
| Rate for Payer: BCBS Complete |
$10.18
|
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Cofinity Commercial |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.37
|
| Rate for Payer: Healthscope Commercial |
$22.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.64
|
| Rate for Payer: PHP Commercial |
$21.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.55
|
| Rate for Payer: Priority Health SBD |
$16.04
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.59
|
|
|
Service Code
|
NDC 00703115303
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$67.13 |
| Rate for Payer: Aetna American Axle |
$48.48
|
| Rate for Payer: Aetna Commercial |
$63.40
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.48
|
| Rate for Payer: BCBS Complete |
$29.84
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$52.21
|
| Rate for Payer: Cofinity Commercial |
$64.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$67.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.40
|
| Rate for Payer: PHP Commercial |
$63.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.48
|
| Rate for Payer: Priority Health SBD |
$46.99
|
| Rate for Payer: UMR Bronson Commercial |
$27.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.94
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.67
|
|
|
Service Code
|
NDC 71839014325
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna American Axle |
$14.09
|
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna Medicare |
$10.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.09
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$15.17
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.09
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.59
|
|
|
Service Code
|
NDC 00409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna American Axle |
$15.33
|
| Rate for Payer: Aetna Commercial |
$20.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.33
|
| Rate for Payer: Cash Price |
$18.87
|
| Rate for Payer: Cofinity Commercial |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$21.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.05
|
| Rate for Payer: PHP Commercial |
$20.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.33
|
| Rate for Payer: Priority Health SBD |
$14.86
|
| Rate for Payer: UMR Bronson Commercial |
$10.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.69
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$36.17
|
|
|
Service Code
|
NDC 47335061540
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$32.55 |
| Rate for Payer: Aetna American Axle |
$23.51
|
| Rate for Payer: Aetna Commercial |
$30.74
|
| Rate for Payer: Aetna Medicare |
$18.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.51
|
| Rate for Payer: BCBS Complete |
$14.47
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$25.32
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$32.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: PHP Commercial |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.51
|
| Rate for Payer: Priority Health SBD |
$22.79
|
| Rate for Payer: UMR Bronson Commercial |
$13.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.13
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.34
|
|
|
Service Code
|
NDC 67457085200
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$16.51 |
| Rate for Payer: Aetna American Axle |
$11.92
|
| Rate for Payer: Aetna Commercial |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.92
|
| Rate for Payer: Cash Price |
$14.67
|
| Rate for Payer: Cofinity Commercial |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$15.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$16.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.59
|
| Rate for Payer: PHP Commercial |
$15.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.92
|
| Rate for Payer: Priority Health SBD |
$11.55
|
| Rate for Payer: UMR Bronson Commercial |
$8.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.76
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.78
|
|
|
Service Code
|
NDC 63323094004
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.69 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Aetna American Axle |
$13.51
|
| Rate for Payer: Aetna Commercial |
$17.66
|
| Rate for Payer: Aetna Medicare |
$10.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.51
|
| Rate for Payer: BCBS Complete |
$8.31
|
| Rate for Payer: Cash Price |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.55
|
| Rate for Payer: Cofinity Commercial |
$17.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$18.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.66
|
| Rate for Payer: PHP Commercial |
$17.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health SBD |
$13.09
|
| Rate for Payer: UMR Bronson Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.58
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.78
|
|
|
Service Code
|
NDC 63323094004
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Aetna American Axle |
$13.51
|
| Rate for Payer: Aetna Commercial |
$17.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.51
|
| Rate for Payer: Cash Price |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.55
|
| Rate for Payer: Cofinity Commercial |
$17.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$18.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.66
|
| Rate for Payer: PHP Commercial |
$17.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health SBD |
$13.09
|
| Rate for Payer: UMR Bronson Commercial |
$9.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.58
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.34
|
|
|
Service Code
|
NDC 67457085204
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$16.51 |
| Rate for Payer: Aetna American Axle |
$11.92
|
| Rate for Payer: Aetna Commercial |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.92
|
| Rate for Payer: Cash Price |
$14.67
|
| Rate for Payer: Cofinity Commercial |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$15.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$16.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.59
|
| Rate for Payer: PHP Commercial |
$15.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.92
|
| Rate for Payer: Priority Health SBD |
$11.55
|
| Rate for Payer: UMR Bronson Commercial |
$8.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.76
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.25
|
|
|
Service Code
|
NDC 36000016210
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$18.22 |
| Rate for Payer: Aetna American Axle |
$13.16
|
| Rate for Payer: Aetna Commercial |
$17.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.16
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cofinity Commercial |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.20
|
| Rate for Payer: Healthscope Commercial |
$18.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.21
|
| Rate for Payer: PHP Commercial |
$17.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.16
|
| Rate for Payer: Priority Health SBD |
$12.76
|
| Rate for Payer: UMR Bronson Commercial |
$8.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.19
|
|
|
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
NDC 81298965503
|
| Hospital Charge Code |
119763
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna American Axle |
$18.20
|
| Rate for Payer: Aetna Commercial |
$23.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$19.60
|
| Rate for Payer: Cofinity Commercial |
$24.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.40
|
| Rate for Payer: Healthscope Commercial |
$25.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.80
|
| Rate for Payer: PHP Commercial |
$23.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health SBD |
$17.64
|
| Rate for Payer: UMR Bronson Commercial |
$12.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.00
|
|
|
NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) INFUSION
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
NDC 81298965501
|
| Hospital Charge Code |
119763
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna American Axle |
$18.20
|
| Rate for Payer: Aetna Commercial |
$23.80
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.20
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$19.60
|
| Rate for Payer: Cofinity Commercial |
$24.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.40
|
| Rate for Payer: Healthscope Commercial |
$25.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.80
|
| Rate for Payer: PHP Commercial |
$23.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health SBD |
$17.64
|
| Rate for Payer: UMR Bronson Commercial |
$10.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.00
|
|
