|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.70
|
|
|
Service Code
|
NDC 43066099701
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.53 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna Commercial |
$18.63
|
| Rate for Payer: ASR ASR |
$20.08
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cofinity Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Whirlpool |
$20.70
|
| Rate for Payer: Mclaren Commercial |
$18.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.22
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.98
|
|
|
Service Code
|
NDC 67457085204
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$13.48
|
| Rate for Payer: Aetna Medicare |
$5.54
|
| Rate for Payer: ASR ASR |
$14.53
|
| Rate for Payer: BCBS Complete |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$12.35
|
| Rate for Payer: BCN Commercial |
$12.35
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$14.53
|
| Rate for Payer: Healthscope Whirlpool |
$14.98
|
| Rate for Payer: Mclaren Commercial |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.73
|
| Rate for Payer: Nomi Health Commercial |
$12.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.12
|
| Rate for Payer: Priority Health Narrow Network |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.18
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.10
|
|
|
Service Code
|
NDC 781375595
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Medicare |
$8.92
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS Trust/PPO |
$19.87
|
| Rate for Payer: BCN Commercial |
$19.87
|
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Cofinity Commercial |
$22.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Healthscope Whirlpool |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$21.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.11
|
| Rate for Payer: Priority Health Narrow Network |
$16.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14.98
|
|
|
Service Code
|
NDC 67457085200
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$13.48
|
| Rate for Payer: ASR ASR |
$14.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$14.53
|
| Rate for Payer: Healthscope Whirlpool |
$14.98
|
| Rate for Payer: Mclaren Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.73
|
| Rate for Payer: Nomi Health Commercial |
$12.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.18
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.64
|
|
|
Service Code
|
NDC 51991098399
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.98 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$18.60
|
| Rate for Payer: BCN Commercial |
$18.60
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$21.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.93
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$74.58
|
|
|
Service Code
|
NDC 703115303
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$74.58 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$27.60
|
| Rate for Payer: ASR ASR |
$72.34
|
| Rate for Payer: BCBS Complete |
$29.83
|
| Rate for Payer: BCBS Trust/PPO |
$61.49
|
| Rate for Payer: BCN Commercial |
$61.49
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$72.34
|
| Rate for Payer: Healthscope Whirlpool |
$74.58
|
| Rate for Payer: Mclaren Commercial |
$67.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.39
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.35
|
| Rate for Payer: Priority Health Narrow Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.63
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
NDC 143931801
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: Aetna Medicare |
$9.98
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: BCBS Complete |
$10.79
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCN Commercial |
$22.24
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.63
|
| Rate for Payer: Priority Health Narrow Network |
$18.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.58
|
|
|
Service Code
|
NDC 703115303
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$55.94 |
| Max. Negotiated Rate |
$74.58 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: ASR ASR |
$72.34
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$72.34
|
| Rate for Payer: Healthscope Whirlpool |
$74.58
|
| Rate for Payer: Mclaren Commercial |
$67.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.39
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.63
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.70
|
|
|
Service Code
|
NDC 43066099710
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Aetna Commercial |
$18.63
|
| Rate for Payer: Aetna Medicare |
$7.66
|
| Rate for Payer: ASR ASR |
$20.08
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$17.07
|
| Rate for Payer: BCN Commercial |
$17.07
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cofinity Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Whirlpool |
$20.70
|
| Rate for Payer: Mclaren Commercial |
$18.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.14
|
| Rate for Payer: Priority Health Narrow Network |
$14.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.22
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.10
|
|
|
Service Code
|
NDC 781375575
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Medicare |
$8.92
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS Trust/PPO |
$19.87
|
| Rate for Payer: BCN Commercial |
$19.87
|
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Cofinity Commercial |
$22.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Healthscope Whirlpool |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$21.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.11
|
| Rate for Payer: Priority Health Narrow Network |
$16.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
NDC 143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: Aetna Medicare |
$9.98
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: BCBS Complete |
$10.79
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCN Commercial |
$22.24
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.63
|
| Rate for Payer: Priority Health Narrow Network |
$18.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.24
|
|
|
Service Code
|
NDC 36000016201
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$20.24 |
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Medicare |
$7.49
|
| Rate for Payer: ASR ASR |
$19.63
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS Trust/PPO |
$16.69
|
| Rate for Payer: BCN Commercial |
$16.69
|
| Rate for Payer: Cash Price |
$16.19
|
| Rate for Payer: Cofinity Commercial |
$19.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.19
|
| Rate for Payer: Healthscope Commercial |
$19.63
|
| Rate for Payer: Healthscope Whirlpool |
$20.24
|
| Rate for Payer: Mclaren Commercial |
$18.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.21
|
| Rate for Payer: Nomi Health Commercial |
$16.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17.74
|
| Rate for Payer: Priority Health Narrow Network |
$14.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.81
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.83
|
|
|
Service Code
|
NDC 70121157607
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.87 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$21.45
|
| Rate for Payer: ASR ASR |
$23.11
|
| Rate for Payer: BCBS Trust/PPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: Cash Price |
$19.06
|
| Rate for Payer: Cofinity Commercial |
$22.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.06
|
| Rate for Payer: Healthscope Commercial |
$23.11
|
| Rate for Payer: Healthscope Whirlpool |
$23.83
|
| Rate for Payer: Mclaren Commercial |
$21.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.25
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.97
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.62
|
|
|
Service Code
|
NDC 409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$18.62 |
| Rate for Payer: Aetna Commercial |
$16.76
|
| Rate for Payer: Aetna Medicare |
$6.89
|
| Rate for Payer: ASR ASR |
$18.06
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS Trust/PPO |
$15.35
|
| Rate for Payer: BCN Commercial |
$15.35
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$18.06
|
| Rate for Payer: Healthscope Whirlpool |
$18.62
|
| Rate for Payer: Mclaren Commercial |
$16.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.31
|
| Rate for Payer: Priority Health Narrow Network |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.38
|
|
|
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 |
$36.17 |
| Rate for Payer: Aetna Commercial |
$32.55
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: ASR ASR |
$35.08
|
| Rate for Payer: BCBS Complete |
$14.47
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$29.82
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$34.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$35.08
|
| Rate for Payer: Healthscope Whirlpool |
$36.17
|
| Rate for Payer: Mclaren Commercial |
$32.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: Nomi Health Commercial |
$29.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.69
|
| Rate for Payer: Priority Health Narrow Network |
$25.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.83
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
NDC 143931801
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: BCBS Trust/PPO |
$22.15
|
| Rate for Payer: BCN Commercial |
$22.15
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.24
|
|
|
Service Code
|
NDC 36000016210
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$20.24 |
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: ASR ASR |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$16.62
|
| Rate for Payer: BCN Commercial |
$16.62
|
| Rate for Payer: Cash Price |
$16.19
|
| Rate for Payer: Cofinity Commercial |
$19.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.19
|
| Rate for Payer: Healthscope Commercial |
$19.63
|
| Rate for Payer: Healthscope Whirlpool |
$20.24
|
| Rate for Payer: Mclaren Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.21
|
| Rate for Payer: Nomi Health Commercial |
$16.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.81
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.83
|
|
|
Service Code
|
NDC 70121157601
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.87 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$21.45
|
| Rate for Payer: ASR ASR |
$23.11
|
| Rate for Payer: BCBS Trust/PPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: Cash Price |
$19.06
|
| Rate for Payer: Cofinity Commercial |
$22.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.06
|
| Rate for Payer: Healthscope Commercial |
$23.11
|
| Rate for Payer: Healthscope Whirlpool |
$23.83
|
| Rate for Payer: Mclaren Commercial |
$21.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.25
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.97
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14.98
|
|
|
Service Code
|
NDC 67457085200
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$13.48
|
| Rate for Payer: Aetna Medicare |
$5.54
|
| Rate for Payer: ASR ASR |
$14.53
|
| Rate for Payer: BCBS Complete |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$12.35
|
| Rate for Payer: BCN Commercial |
$12.35
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$14.53
|
| Rate for Payer: Healthscope Whirlpool |
$14.98
|
| Rate for Payer: Mclaren Commercial |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.73
|
| Rate for Payer: Nomi Health Commercial |
$12.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.12
|
| Rate for Payer: Priority Health Narrow Network |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.18
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
NDC 143931810
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$24.27
|
| Rate for Payer: ASR ASR |
$26.16
|
| Rate for Payer: BCBS Trust/PPO |
$22.15
|
| Rate for Payer: BCN Commercial |
$22.15
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$25.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.97
|
| Rate for Payer: Mclaren Commercial |
$24.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.73
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.64
|
|
|
Service Code
|
NDC 51991098317
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: BCBS Complete |
$9.06
|
| Rate for Payer: BCBS Trust/PPO |
$18.67
|
| Rate for Payer: BCN Commercial |
$18.67
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$21.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.84
|
| Rate for Payer: Priority Health Narrow Network |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.93
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.58
|
|
|
Service Code
|
NDC 703115301
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$55.94 |
| Max. Negotiated Rate |
$74.58 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: ASR ASR |
$72.34
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$59.67
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$72.34
|
| Rate for Payer: Healthscope Whirlpool |
$74.58
|
| Rate for Payer: Mclaren Commercial |
$67.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.39
|
| Rate for Payer: Nomi Health Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.63
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.10
|
|
|
Service Code
|
NDC 781375575
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.79
|
| Rate for Payer: BCN Commercial |
$19.79
|
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Cofinity Commercial |
$22.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Healthscope Whirlpool |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.64
|
|
|
Service Code
|
NDC 51991098317
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.98 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$18.60
|
| Rate for Payer: BCN Commercial |
$18.60
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$21.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.93
|
|
|
NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.62
|
|
|
Service Code
|
NDC 409337504
|
| Hospital Charge Code |
10734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$18.62 |
| Rate for Payer: Aetna Commercial |
$16.76
|
| Rate for Payer: ASR ASR |
$18.06
|
| Rate for Payer: BCBS Trust/PPO |
$15.29
|
| Rate for Payer: BCN Commercial |
$15.29
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$18.06
|
| Rate for Payer: Healthscope Whirlpool |
$18.62
|
| Rate for Payer: Mclaren Commercial |
$16.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.38
|
|
