|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$83.67
|
|
|
Service Code
|
NDC 65862039010
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.96 |
| Max. Negotiated Rate |
$75.30 |
| Rate for Payer: Aetna American Axle |
$54.39
|
| Rate for Payer: Aetna Commercial |
$71.12
|
| Rate for Payer: Aetna Medicare |
$41.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.39
|
| Rate for Payer: BCBS Complete |
$33.47
|
| Rate for Payer: Cash Price |
$66.94
|
| Rate for Payer: Cofinity Commercial |
$58.57
|
| Rate for Payer: Cofinity Commercial |
$71.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.94
|
| Rate for Payer: Healthscope Commercial |
$75.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.12
|
| Rate for Payer: PHP Commercial |
$71.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.39
|
| Rate for Payer: Priority Health SBD |
$52.71
|
| Rate for Payer: UMR Bronson Commercial |
$30.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.75
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$81.94
|
|
|
Service Code
|
NDC 00378773293
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$73.75 |
| Rate for Payer: Aetna American Axle |
$53.26
|
| Rate for Payer: Aetna Commercial |
$69.65
|
| Rate for Payer: Aetna Medicare |
$40.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.26
|
| Rate for Payer: BCBS Complete |
$32.78
|
| Rate for Payer: Cash Price |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$57.36
|
| Rate for Payer: Cofinity Commercial |
$70.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.55
|
| Rate for Payer: Healthscope Commercial |
$73.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.65
|
| Rate for Payer: PHP Commercial |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.26
|
| Rate for Payer: Priority Health SBD |
$51.62
|
| Rate for Payer: UMR Bronson Commercial |
$30.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.46
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$81.94
|
|
|
Service Code
|
NDC 62756024064
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$73.75 |
| Rate for Payer: Cash Price |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$57.36
|
| Rate for Payer: Cofinity Commercial |
$70.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.36
|
| Rate for Payer: Aetna American Axle |
$53.26
|
| Rate for Payer: Aetna Commercial |
$69.65
|
| Rate for Payer: Aetna Medicare |
$40.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.26
|
| Rate for Payer: BCBS Complete |
$32.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.55
|
| Rate for Payer: Healthscope Commercial |
$73.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.65
|
| Rate for Payer: PHP Commercial |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.26
|
| Rate for Payer: Priority Health SBD |
$51.62
|
| Rate for Payer: UMR Bronson Commercial |
$30.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.46
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$137.48
|
|
|
Service Code
|
NDC 68462015713
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.49 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Aetna American Axle |
$89.36
|
| Rate for Payer: Aetna Commercial |
$116.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.36
|
| Rate for Payer: Cash Price |
$109.98
|
| Rate for Payer: Cofinity Commercial |
$118.23
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.98
|
| Rate for Payer: Healthscope Commercial |
$123.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.86
|
| Rate for Payer: PHP Commercial |
$116.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.36
|
| Rate for Payer: Priority Health SBD |
$86.61
|
| Rate for Payer: UMR Bronson Commercial |
$60.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.11
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$4.59
|
|
|
Service Code
|
NDC 68462015740
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna American Axle |
$2.98
|
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$3.21
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.98
|
| Rate for Payer: Priority Health SBD |
$2.89
|
| Rate for Payer: UMR Bronson Commercial |
$2.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$137.48
|
|
|
Service Code
|
NDC 68462015713
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.87 |
| Max. Negotiated Rate |
$123.73 |
| Rate for Payer: Aetna American Axle |
$89.36
|
| Rate for Payer: Aetna Commercial |
$116.86
|
| Rate for Payer: Aetna Medicare |
$68.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.36
|
| Rate for Payer: BCBS Complete |
$54.99
|
| Rate for Payer: Cash Price |
$109.98
|
| Rate for Payer: Cofinity Commercial |
$118.23
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.98
|
| Rate for Payer: Healthscope Commercial |
$123.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.86
|
| Rate for Payer: PHP Commercial |
$116.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.36
|
| Rate for Payer: Priority Health SBD |
$86.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.11
|
|
|
ONDANSETRON 4 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$4.59
|
|
|
Service Code
|
NDC 68462015740
|
| Hospital Charge Code |
27697
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna American Axle |
$2.98
|
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna Medicare |
$2.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$3.21
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.98
|
| Rate for Payer: Priority Health SBD |
$2.89
|
| Rate for Payer: UMR Bronson Commercial |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
|
|
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$105.50
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
10777
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.42 |
| Max. Negotiated Rate |
$94.95 |
| Rate for Payer: Aetna American Axle |
$68.58
|
| Rate for Payer: Aetna American Axle |
$37.70
|
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna American Axle |
$96.52
|
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna American Axle |
$107.90
|
| Rate for Payer: Aetna American Axle |
$53.95
|
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: Aetna Commercial |
$126.22
|
| Rate for Payer: Aetna Commercial |
$89.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$84.40
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Cofinity Commercial |
$73.85
|
| Rate for Payer: Cofinity Commercial |
$142.76
|
| Rate for Payer: Cofinity Commercial |
$116.20
|
| Rate for Payer: Cofinity Commercial |
$103.95
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Cofinity Commercial |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$127.71
|
| Rate for Payer: Cofinity Commercial |
$90.73
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$40.60
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.40
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Commercial |
$133.65
|
| Rate for Payer: Healthscope Commercial |
$149.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Healthscope Commercial |
$94.95
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.30
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$126.22
|
| Rate for Payer: PHP Commercial |
$141.10
|
| Rate for Payer: PHP Commercial |
$89.68
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$93.56
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: Priority Health SBD |
$66.46
|
| Rate for Payer: Priority Health SBD |
$52.29
|
| Rate for Payer: Priority Health SBD |
$36.54
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Priority Health SBD |
$104.58
|
| Rate for Payer: UMR Bronson Commercial |
$73.04
|
| Rate for Payer: UMR Bronson Commercial |
$36.52
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: UMR Bronson Commercial |
$25.52
|
| Rate for Payer: UMR Bronson Commercial |
$46.42
|
| Rate for Payer: UMR Bronson Commercial |
$65.34
|
| Rate for Payer: UMR Bronson Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.12
|
|
|
ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
10777
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna American Axle |
$53.95
|
| Rate for Payer: Aetna American Axle |
$40.62
|
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna American Axle |
$107.90
|
| Rate for Payer: Aetna American Axle |
$37.70
|
| Rate for Payer: Aetna American Axle |
$68.58
|
| Rate for Payer: Aetna American Axle |
$96.52
|
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$126.22
|
| Rate for Payer: Aetna Commercial |
$89.68
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna Commercial |
$53.12
|
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: Aetna Medicare |
$83.00
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna Medicare |
$31.25
|
| Rate for Payer: Aetna Medicare |
$74.25
|
| Rate for Payer: Aetna Medicare |
$41.50
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna Medicare |
$52.75
|
| Rate for Payer: Aetna Medicare |
$29.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS Complete |
$42.20
|
| Rate for Payer: BCBS Complete |
$59.40
|
| Rate for Payer: BCBS Complete |
$25.00
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$84.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$84.40
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$116.20
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Cofinity Commercial |
$40.60
|
| Rate for Payer: Cofinity Commercial |
$73.85
|
| Rate for Payer: Cofinity Commercial |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Cofinity Commercial |
$142.76
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$103.95
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Cofinity Commercial |
$90.73
|
| Rate for Payer: Cofinity Commercial |
$127.71
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$43.75
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.40
|
| Rate for Payer: Healthscope Commercial |
$133.65
|
| Rate for Payer: Healthscope Commercial |
$149.40
|
| Rate for Payer: Healthscope Commercial |
$56.25
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Healthscope Commercial |
$94.95
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.10
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$89.68
|
| Rate for Payer: PHP Commercial |
$126.22
|
| Rate for Payer: PHP Commercial |
$53.12
|
| Rate for Payer: PHP Commercial |
$141.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.62
|
| Rate for Payer: Priority Health SBD |
$66.46
|
| Rate for Payer: Priority Health SBD |
$52.29
|
| Rate for Payer: Priority Health SBD |
$104.58
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: Priority Health SBD |
$93.56
|
| Rate for Payer: Priority Health SBD |
$39.38
|
| Rate for Payer: Priority Health SBD |
$36.54
|
| Rate for Payer: UMR Bronson Commercial |
$23.12
|
| Rate for Payer: UMR Bronson Commercial |
$30.71
|
| Rate for Payer: UMR Bronson Commercial |
$21.46
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: UMR Bronson Commercial |
$61.42
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: UMR Bronson Commercial |
$39.04
|
| Rate for Payer: UMR Bronson Commercial |
$54.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.12
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$14.30
|
|
|
Service Code
|
NDC 09900000346
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Aetna American Axle |
$9.30
|
| Rate for Payer: Aetna Commercial |
$12.16
|
| Rate for Payer: Aetna Medicare |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.30
|
| Rate for Payer: BCBS Complete |
$5.72
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cofinity Commercial |
$10.01
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.16
|
| Rate for Payer: PHP Commercial |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.30
|
| Rate for Payer: Priority Health SBD |
$9.01
|
| Rate for Payer: UMR Bronson Commercial |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$115.43
|
|
|
Service Code
|
NDC 65162069179
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.71 |
| Max. Negotiated Rate |
$103.89 |
| Rate for Payer: Aetna American Axle |
$75.03
|
| Rate for Payer: Aetna Commercial |
$98.12
|
| Rate for Payer: Aetna Medicare |
$57.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.03
|
| Rate for Payer: BCBS Complete |
$46.17
|
| Rate for Payer: Cash Price |
$92.34
|
| Rate for Payer: Cofinity Commercial |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$99.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.34
|
| Rate for Payer: Healthscope Commercial |
$103.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.12
|
| Rate for Payer: PHP Commercial |
$98.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.03
|
| Rate for Payer: Priority Health SBD |
$72.72
|
| Rate for Payer: UMR Bronson Commercial |
$42.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.57
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$115.43
|
|
|
Service Code
|
NDC 65162069179
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.79 |
| Max. Negotiated Rate |
$103.89 |
| Rate for Payer: Aetna American Axle |
$75.03
|
| Rate for Payer: Aetna Commercial |
$98.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.03
|
| Rate for Payer: Cash Price |
$92.34
|
| Rate for Payer: Cofinity Commercial |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$99.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.34
|
| Rate for Payer: Healthscope Commercial |
$103.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.12
|
| Rate for Payer: PHP Commercial |
$98.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.03
|
| Rate for Payer: Priority Health SBD |
$72.72
|
| Rate for Payer: UMR Bronson Commercial |
$50.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.57
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$382.80
|
|
|
Service Code
|
NDC 00054006447
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$168.43 |
| Max. Negotiated Rate |
$344.52 |
| Rate for Payer: Aetna American Axle |
$248.82
|
| Rate for Payer: Aetna Commercial |
$325.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.82
|
| Rate for Payer: Cash Price |
$306.24
|
| Rate for Payer: Cofinity Commercial |
$267.96
|
| Rate for Payer: Cofinity Commercial |
$329.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.24
|
| Rate for Payer: Healthscope Commercial |
$344.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.38
|
| Rate for Payer: PHP Commercial |
$325.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.82
|
| Rate for Payer: Priority Health SBD |
$241.16
|
| Rate for Payer: UMR Bronson Commercial |
$168.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.10
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$14.30
|
|
|
Service Code
|
NDC 09900000346
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Aetna American Axle |
$9.30
|
| Rate for Payer: Aetna Commercial |
$12.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.30
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cofinity Commercial |
$10.01
|
| Rate for Payer: Cofinity Commercial |
$12.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.16
|
| Rate for Payer: PHP Commercial |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.30
|
| Rate for Payer: Priority Health SBD |
$9.01
|
| Rate for Payer: UMR Bronson Commercial |
$6.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$220.88
|
|
|
Service Code
|
NDC 54838055550
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.19 |
| Max. Negotiated Rate |
$198.79 |
| Rate for Payer: Aetna American Axle |
$143.57
|
| Rate for Payer: Aetna Commercial |
$187.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.57
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cofinity Commercial |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$189.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.70
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.75
|
| Rate for Payer: PHP Commercial |
$187.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.57
|
| Rate for Payer: Priority Health SBD |
$139.15
|
| Rate for Payer: UMR Bronson Commercial |
$97.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.66
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$220.88
|
|
|
Service Code
|
NDC 54838055550
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$198.79 |
| Rate for Payer: Aetna American Axle |
$143.57
|
| Rate for Payer: Aetna Commercial |
$187.75
|
| Rate for Payer: Aetna Medicare |
$110.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.57
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cofinity Commercial |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$189.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.70
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.75
|
| Rate for Payer: PHP Commercial |
$187.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.57
|
| Rate for Payer: Priority Health SBD |
$139.15
|
| Rate for Payer: UMR Bronson Commercial |
$81.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.66
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$382.80
|
|
|
Service Code
|
NDC 00054006447
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.64 |
| Max. Negotiated Rate |
$344.52 |
| Rate for Payer: Aetna American Axle |
$248.82
|
| Rate for Payer: Aetna Commercial |
$325.38
|
| Rate for Payer: Aetna Medicare |
$191.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.82
|
| Rate for Payer: BCBS Complete |
$153.12
|
| Rate for Payer: Cash Price |
$306.24
|
| Rate for Payer: Cofinity Commercial |
$267.96
|
| Rate for Payer: Cofinity Commercial |
$329.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.24
|
| Rate for Payer: Healthscope Commercial |
$344.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.38
|
| Rate for Payer: PHP Commercial |
$325.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.82
|
| Rate for Payer: Priority Health SBD |
$241.16
|
| Rate for Payer: UMR Bronson Commercial |
$141.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.10
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$151.53
|
|
|
Service Code
|
NDC 51672409103
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.07 |
| Max. Negotiated Rate |
$136.38 |
| Rate for Payer: Aetna American Axle |
$98.49
|
| Rate for Payer: Aetna Commercial |
$128.80
|
| Rate for Payer: Aetna Medicare |
$75.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.49
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: Cash Price |
$121.22
|
| Rate for Payer: Cofinity Commercial |
$106.07
|
| Rate for Payer: Cofinity Commercial |
$130.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.22
|
| Rate for Payer: Healthscope Commercial |
$136.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.80
|
| Rate for Payer: PHP Commercial |
$128.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.49
|
| Rate for Payer: Priority Health SBD |
$95.46
|
| Rate for Payer: UMR Bronson Commercial |
$56.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.65
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$151.53
|
|
|
Service Code
|
NDC 51672409103
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$136.38 |
| Rate for Payer: Aetna American Axle |
$98.49
|
| Rate for Payer: Aetna Commercial |
$128.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.49
|
| Rate for Payer: Cash Price |
$121.22
|
| Rate for Payer: Cofinity Commercial |
$106.07
|
| Rate for Payer: Cofinity Commercial |
$130.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.22
|
| Rate for Payer: Healthscope Commercial |
$136.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.80
|
| Rate for Payer: PHP Commercial |
$128.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.49
|
| Rate for Payer: Priority Health SBD |
$95.46
|
| Rate for Payer: UMR Bronson Commercial |
$66.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.65
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$195.23
|
|
|
Service Code
|
NDC 50268062115
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.24 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna American Axle |
$126.90
|
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: Aetna Medicare |
$97.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.90
|
| Rate for Payer: BCBS Complete |
$78.09
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$136.66
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.95
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.90
|
| Rate for Payer: Priority Health SBD |
$122.99
|
| Rate for Payer: UMR Bronson Commercial |
$72.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$119.99
|
|
|
Service Code
|
NDC 45963053830
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$107.99 |
| Rate for Payer: Aetna American Axle |
$77.99
|
| Rate for Payer: Aetna Commercial |
$101.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.99
|
| Rate for Payer: Cash Price |
$95.99
|
| Rate for Payer: Cofinity Commercial |
$103.19
|
| Rate for Payer: Cofinity Commercial |
$83.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.99
|
| Rate for Payer: Healthscope Commercial |
$107.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.99
|
| Rate for Payer: PHP Commercial |
$101.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.99
|
| Rate for Payer: Priority Health SBD |
$75.59
|
| Rate for Payer: UMR Bronson Commercial |
$52.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.99
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$3.91
|
|
|
Service Code
|
NDC 50268062111
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$3.52 |
| Rate for Payer: Aetna American Axle |
$2.54
|
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: Aetna Medicare |
$1.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.54
|
| Rate for Payer: BCBS Complete |
$1.56
|
| Rate for Payer: Cash Price |
$3.13
|
| Rate for Payer: Cofinity Commercial |
$2.74
|
| Rate for Payer: Cofinity Commercial |
$3.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.13
|
| Rate for Payer: Healthscope Commercial |
$3.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.32
|
| Rate for Payer: PHP Commercial |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.54
|
| Rate for Payer: Priority Health SBD |
$2.46
|
| Rate for Payer: UMR Bronson Commercial |
$1.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.93
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$82.08
|
|
|
Service Code
|
NDC 62756013001
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.12 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Aetna American Axle |
$53.35
|
| Rate for Payer: Aetna Commercial |
$69.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.35
|
| Rate for Payer: Cash Price |
$65.66
|
| Rate for Payer: Cofinity Commercial |
$57.46
|
| Rate for Payer: Cofinity Commercial |
$70.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.66
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.77
|
| Rate for Payer: PHP Commercial |
$69.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.35
|
| Rate for Payer: Priority Health SBD |
$51.71
|
| Rate for Payer: UMR Bronson Commercial |
$36.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.56
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$82.08
|
|
|
Service Code
|
NDC 62756013001
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.37 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Aetna American Axle |
$53.35
|
| Rate for Payer: Aetna Commercial |
$69.77
|
| Rate for Payer: Aetna Medicare |
$41.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.35
|
| Rate for Payer: BCBS Complete |
$32.83
|
| Rate for Payer: Cash Price |
$65.66
|
| Rate for Payer: Cofinity Commercial |
$57.46
|
| Rate for Payer: Cofinity Commercial |
$70.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.66
|
| Rate for Payer: Healthscope Commercial |
$73.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.77
|
| Rate for Payer: PHP Commercial |
$69.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.35
|
| Rate for Payer: Priority Health SBD |
$51.71
|
| Rate for Payer: UMR Bronson Commercial |
$30.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.56
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
NDC 00904655161
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.45 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna American Axle |
$185.25
|
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: Aetna Medicare |
$142.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.25
|
| Rate for Payer: BCBS Complete |
$114.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$199.50
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$199.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health SBD |
$179.55
|
| Rate for Payer: UMR Bronson Commercial |
$105.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
