|
PAROXETINE 10 MG TABLET
|
Facility
|
OP
|
$270.72
|
|
|
Service Code
|
NDC 00904567661
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.17 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna American Axle |
$175.97
|
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna Medicare |
$135.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: BCBS Complete |
$108.29
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Advantage |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health SBD |
$170.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.97
|
| Rate for Payer: UHC Core |
$141.05
|
| Rate for Payer: UHC Exchange |
$106.39
|
| Rate for Payer: UMR Bronson Commercial |
$100.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
PAROXETINE 10 MG TABLET
|
Facility
|
IP
|
$297.60
|
|
|
Service Code
|
NDC 68084004411
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.94 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna American Axle |
$193.44
|
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.44
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Advantage |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: Priority Health SBD |
$187.49
|
| Rate for Payer: UMR Bronson Commercial |
$130.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
PAROXETINE 10 MG TABLET
|
Facility
|
OP
|
$297.60
|
|
|
Service Code
|
NDC 68084004411
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna American Axle |
$193.44
|
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: Aetna Medicare |
$148.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.44
|
| Rate for Payer: BCBS Complete |
$119.04
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Advantage |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: Priority Health SBD |
$187.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.44
|
| Rate for Payer: UHC Core |
$155.05
|
| Rate for Payer: UHC Exchange |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$110.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
PAROXETINE 10 MG TABLET
|
Facility
|
IP
|
$270.72
|
|
|
Service Code
|
NDC 00904567661
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.12 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna American Axle |
$175.97
|
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Advantage |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health SBD |
$170.55
|
| Rate for Payer: UMR Bronson Commercial |
$119.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
PAROXETINE 10 MG TABLET
|
Facility
|
OP
|
$297.60
|
|
|
Service Code
|
NDC 68084004401
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.11 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna American Axle |
$193.44
|
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: Aetna Medicare |
$148.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.44
|
| Rate for Payer: BCBS Complete |
$119.04
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Advantage |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: Priority Health SBD |
$187.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.44
|
| Rate for Payer: UHC Core |
$155.05
|
| Rate for Payer: UHC Exchange |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$110.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
PAROXETINE 10 MG TABLET
|
Facility
|
IP
|
$297.60
|
|
|
Service Code
|
NDC 68084004401
|
| Hospital Charge Code |
16632
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.94 |
| Max. Negotiated Rate |
$267.84 |
| Rate for Payer: Aetna American Axle |
$193.44
|
| Rate for Payer: Aetna Commercial |
$252.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.44
|
| Rate for Payer: Cash Price |
$238.08
|
| Rate for Payer: Cofinity Advantage |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$255.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.08
|
| Rate for Payer: Healthscope Commercial |
$267.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.20
|
| Rate for Payer: PHP Commercial |
$252.96
|
| Rate for Payer: Priority Health SBD |
$187.49
|
| Rate for Payer: UMR Bronson Commercial |
$130.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.20
|
|
|
PAROXETINE 20 MG TABLET
|
Facility
|
IP
|
$425.35
|
|
|
Service Code
|
NDC 00904567761
|
| Hospital Charge Code |
10855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$187.15 |
| Max. Negotiated Rate |
$382.81 |
| Rate for Payer: Aetna American Axle |
$276.48
|
| Rate for Payer: Aetna Commercial |
$361.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.48
|
| Rate for Payer: Cash Price |
$340.28
|
| Rate for Payer: Cofinity Advantage |
$297.75
|
| Rate for Payer: Cofinity Commercial |
$365.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.28
|
| Rate for Payer: Healthscope Commercial |
$382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.01
|
| Rate for Payer: PHP Commercial |
$361.55
|
| Rate for Payer: Priority Health SBD |
$267.97
|
| Rate for Payer: UMR Bronson Commercial |
$187.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.01
|
|
|
PAROXETINE 20 MG TABLET
|
Facility
|
OP
|
$425.35
|
|
|
Service Code
|
NDC 00904567761
|
| Hospital Charge Code |
10855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.38 |
| Max. Negotiated Rate |
$382.81 |
| Rate for Payer: Aetna American Axle |
$276.48
|
| Rate for Payer: Aetna Commercial |
$361.55
|
| Rate for Payer: Aetna Medicare |
$212.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.48
|
| Rate for Payer: BCBS Complete |
$170.14
|
| Rate for Payer: Cash Price |
$340.28
|
| Rate for Payer: Cofinity Advantage |
$297.75
|
| Rate for Payer: Cofinity Commercial |
$365.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.28
|
| Rate for Payer: Healthscope Commercial |
$382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.01
|
| Rate for Payer: PHP Commercial |
$361.55
|
| Rate for Payer: Priority Health SBD |
$267.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.48
|
| Rate for Payer: UHC Core |
$221.61
|
| Rate for Payer: UHC Exchange |
$167.16
|
| Rate for Payer: UMR Bronson Commercial |
$157.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.01
|
|
|
PAROXETINE 20 MG TABLET
|
Facility
|
OP
|
$467.65
|
|
|
Service Code
|
NDC 68084004511
|
| Hospital Charge Code |
10855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.03 |
| Max. Negotiated Rate |
$420.88 |
| Rate for Payer: Aetna American Axle |
$303.97
|
| Rate for Payer: Aetna Commercial |
$397.50
|
| Rate for Payer: Aetna Medicare |
$233.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.97
|
| Rate for Payer: BCBS Complete |
$187.06
|
| Rate for Payer: Cash Price |
$374.12
|
| Rate for Payer: Cofinity Advantage |
$327.36
|
| Rate for Payer: Cofinity Commercial |
$402.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.12
|
| Rate for Payer: Healthscope Commercial |
$420.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$350.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$350.74
|
| Rate for Payer: PHP Commercial |
$397.50
|
| Rate for Payer: Priority Health SBD |
$294.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.97
|
| Rate for Payer: UHC Core |
$243.65
|
| Rate for Payer: UHC Exchange |
$183.79
|
| Rate for Payer: UMR Bronson Commercial |
$173.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$350.74
|
|
|
PAROXETINE 20 MG TABLET
|
Facility
|
IP
|
$467.65
|
|
|
Service Code
|
NDC 68084004511
|
| Hospital Charge Code |
10855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$205.77 |
| Max. Negotiated Rate |
$420.88 |
| Rate for Payer: Aetna American Axle |
$303.97
|
| Rate for Payer: Aetna Commercial |
$397.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.97
|
| Rate for Payer: Cash Price |
$374.12
|
| Rate for Payer: Cofinity Advantage |
$327.36
|
| Rate for Payer: Cofinity Commercial |
$402.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.12
|
| Rate for Payer: Healthscope Commercial |
$420.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$350.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$350.74
|
| Rate for Payer: PHP Commercial |
$397.50
|
| Rate for Payer: Priority Health SBD |
$294.62
|
| Rate for Payer: UMR Bronson Commercial |
$205.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$350.74
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$3.42
|
|
|
Service Code
|
NDC 50268064211
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$3.08 |
| Rate for Payer: Aetna American Axle |
$2.22
|
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.22
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Advantage |
$2.39
|
| Rate for Payer: Cofinity Commercial |
$2.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.56
|
| Rate for Payer: PHP Commercial |
$2.91
|
| Rate for Payer: Priority Health SBD |
$2.15
|
| Rate for Payer: UMR Bronson Commercial |
$1.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.56
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$126.20
|
|
|
Service Code
|
NDC 60505008401
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$55.53 |
| Max. Negotiated Rate |
$113.58 |
| Rate for Payer: Aetna American Axle |
$82.03
|
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.03
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Advantage |
$88.34
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Healthscope Commercial |
$113.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: Priority Health SBD |
$79.51
|
| Rate for Payer: UMR Bronson Commercial |
$55.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$3.87
|
|
|
Service Code
|
NDC 68084004611
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna American Axle |
$2.52
|
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Advantage |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.10
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health SBD |
$2.44
|
| Rate for Payer: UMR Bronson Commercial |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.90
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$171.00
|
|
|
Service Code
|
NDC 50268064215
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.27 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Aetna American Axle |
$111.15
|
| Rate for Payer: Aetna Commercial |
$145.35
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.15
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Advantage |
$119.70
|
| Rate for Payer: Cofinity Commercial |
$147.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.80
|
| Rate for Payer: Healthscope Commercial |
$153.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: PHP Commercial |
$145.35
|
| Rate for Payer: Priority Health SBD |
$107.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.15
|
| Rate for Payer: UHC Core |
$89.09
|
| Rate for Payer: UHC Exchange |
$67.20
|
| Rate for Payer: UMR Bronson Commercial |
$63.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.25
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$83.19
|
|
|
Service Code
|
NDC 13107015630
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.78 |
| Max. Negotiated Rate |
$74.87 |
| Rate for Payer: Aetna American Axle |
$54.07
|
| Rate for Payer: Aetna Commercial |
$70.71
|
| Rate for Payer: Aetna Medicare |
$41.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.07
|
| Rate for Payer: BCBS Complete |
$33.28
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Cofinity Advantage |
$58.23
|
| Rate for Payer: Cofinity Commercial |
$71.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.55
|
| Rate for Payer: Healthscope Commercial |
$74.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.39
|
| Rate for Payer: PHP Commercial |
$70.71
|
| Rate for Payer: Priority Health SBD |
$52.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.07
|
| Rate for Payer: UHC Core |
$43.34
|
| Rate for Payer: UHC Exchange |
$32.69
|
| Rate for Payer: UMR Bronson Commercial |
$30.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.39
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$3.87
|
|
|
Service Code
|
NDC 68084004611
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$3.48 |
| Rate for Payer: Aetna American Axle |
$2.52
|
| Rate for Payer: Aetna Commercial |
$3.29
|
| Rate for Payer: Aetna Medicare |
$1.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.52
|
| Rate for Payer: BCBS Complete |
$1.55
|
| Rate for Payer: Cash Price |
$3.10
|
| Rate for Payer: Cofinity Advantage |
$2.71
|
| Rate for Payer: Cofinity Commercial |
$3.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.10
|
| Rate for Payer: Healthscope Commercial |
$3.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: Priority Health SBD |
$2.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.52
|
| Rate for Payer: UHC Core |
$2.02
|
| Rate for Payer: UHC Exchange |
$1.52
|
| Rate for Payer: UMR Bronson Commercial |
$1.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.90
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$386.88
|
|
|
Service Code
|
NDC 68084004601
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.15 |
| Max. Negotiated Rate |
$348.19 |
| Rate for Payer: Aetna American Axle |
$251.47
|
| Rate for Payer: Aetna Commercial |
$328.85
|
| Rate for Payer: Aetna Medicare |
$193.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.47
|
| Rate for Payer: BCBS Complete |
$154.75
|
| Rate for Payer: Cash Price |
$309.50
|
| Rate for Payer: Cofinity Advantage |
$270.82
|
| Rate for Payer: Cofinity Commercial |
$332.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.50
|
| Rate for Payer: Healthscope Commercial |
$348.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.16
|
| Rate for Payer: PHP Commercial |
$328.85
|
| Rate for Payer: Priority Health SBD |
$243.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.47
|
| Rate for Payer: UHC Core |
$201.56
|
| Rate for Payer: UHC Exchange |
$152.04
|
| Rate for Payer: UMR Bronson Commercial |
$143.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.16
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$386.88
|
|
|
Service Code
|
NDC 68084004601
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.23 |
| Max. Negotiated Rate |
$348.19 |
| Rate for Payer: Aetna American Axle |
$251.47
|
| Rate for Payer: Aetna Commercial |
$328.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.47
|
| Rate for Payer: Cash Price |
$309.50
|
| Rate for Payer: Cofinity Advantage |
$270.82
|
| Rate for Payer: Cofinity Commercial |
$332.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.50
|
| Rate for Payer: Healthscope Commercial |
$348.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.16
|
| Rate for Payer: PHP Commercial |
$328.85
|
| Rate for Payer: Priority Health SBD |
$243.73
|
| Rate for Payer: UMR Bronson Commercial |
$170.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.16
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
NDC 50268064215
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.24 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Aetna American Axle |
$111.15
|
| Rate for Payer: Aetna Commercial |
$145.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.15
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Advantage |
$119.70
|
| Rate for Payer: Cofinity Commercial |
$147.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.80
|
| Rate for Payer: Healthscope Commercial |
$153.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: PHP Commercial |
$145.35
|
| Rate for Payer: Priority Health SBD |
$107.73
|
| Rate for Payer: UMR Bronson Commercial |
$75.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.25
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
IP
|
$83.19
|
|
|
Service Code
|
NDC 13107015630
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$74.87 |
| Rate for Payer: Aetna American Axle |
$54.07
|
| Rate for Payer: Aetna Commercial |
$70.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.07
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Cofinity Advantage |
$58.23
|
| Rate for Payer: Cofinity Commercial |
$71.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.55
|
| Rate for Payer: Healthscope Commercial |
$74.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.39
|
| Rate for Payer: PHP Commercial |
$70.71
|
| Rate for Payer: Priority Health SBD |
$52.41
|
| Rate for Payer: UMR Bronson Commercial |
$36.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.39
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$3.42
|
|
|
Service Code
|
NDC 50268064211
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$3.08 |
| Rate for Payer: Aetna American Axle |
$2.22
|
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$1.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.22
|
| Rate for Payer: BCBS Complete |
$1.37
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Advantage |
$2.39
|
| Rate for Payer: Cofinity Commercial |
$2.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.56
|
| Rate for Payer: PHP Commercial |
$2.91
|
| Rate for Payer: Priority Health SBD |
$2.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.22
|
| Rate for Payer: UHC Core |
$1.78
|
| Rate for Payer: UHC Exchange |
$1.34
|
| Rate for Payer: UMR Bronson Commercial |
$1.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.56
|
|
|
PAROXETINE 30 MG TABLET
|
Facility
|
OP
|
$126.20
|
|
|
Service Code
|
NDC 60505008401
|
| Hospital Charge Code |
10856
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.69 |
| Max. Negotiated Rate |
$113.58 |
| Rate for Payer: Aetna American Axle |
$82.03
|
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: Aetna Medicare |
$63.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.03
|
| Rate for Payer: BCBS Complete |
$50.48
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Advantage |
$88.34
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Healthscope Commercial |
$113.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: Priority Health SBD |
$79.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.03
|
| Rate for Payer: UHC Core |
$65.75
|
| Rate for Payer: UHC Exchange |
$49.60
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); DISTAL PHALANX OF FINGER
|
Facility
|
OP
|
$5,181.40
|
|
|
Service Code
|
CPT 26236
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.34
|
| Rate for Payer: BCN Commercial |
$1,690.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER
|
Facility
|
OP
|
$5,181.40
|
|
|
Service Code
|
CPT 26235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.87
|
| Rate for Payer: BCN Commercial |
$1,744.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 28120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,095.73
|
| Rate for Payer: BCN Commercial |
$4,095.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
