|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 39822420001
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: ASR Commercial |
$23.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.63
|
| Rate for Payer: BCN Commercial |
$18.68
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$22.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Whirlpool |
$23.37
|
| Rate for Payer: Mclaren Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.86
|
|
|
Service Code
|
NDC 00781322095
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$25.86 |
| Rate for Payer: Aetna Commercial |
$23.27
|
| Rate for Payer: Aetna Medicare |
$12.93
|
| Rate for Payer: ASR ASR |
$25.08
|
| Rate for Payer: ASR Commercial |
$25.08
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS Trust/PPO |
$21.18
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: Cash Price |
$20.69
|
| Rate for Payer: Cofinity Commercial |
$24.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.69
|
| Rate for Payer: Healthscope Commercial |
$25.86
|
| Rate for Payer: Healthscope Whirlpool |
$25.08
|
| Rate for Payer: Mclaren Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.98
|
| Rate for Payer: Nomi Health Commercial |
$21.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.66
|
| Rate for Payer: Priority Health Narrow Network |
$18.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.76
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.54
|
|
|
Service Code
|
NDC 25021066205
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$17.54 |
| Rate for Payer: Aetna Commercial |
$15.79
|
| Rate for Payer: ASR ASR |
$17.01
|
| Rate for Payer: ASR Commercial |
$17.01
|
| Rate for Payer: BCBS Trust/PPO |
$14.29
|
| Rate for Payer: BCN Commercial |
$13.60
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$17.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.01
|
| Rate for Payer: Mclaren Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.91
|
| Rate for Payer: Nomi Health Commercial |
$14.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.44
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 67457022810
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: ASR Commercial |
$28.10
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Whirlpool |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.38
|
| Rate for Payer: Priority Health Narrow Network |
$20.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.73
|
|
|
Service Code
|
NDC 72611075701
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$29.73 |
| Rate for Payer: Aetna Commercial |
$26.76
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: ASR ASR |
$28.84
|
| Rate for Payer: ASR Commercial |
$28.84
|
| Rate for Payer: BCBS Complete |
$11.89
|
| Rate for Payer: BCBS Trust/PPO |
$24.35
|
| Rate for Payer: BCN Commercial |
$23.05
|
| Rate for Payer: Cash Price |
$23.78
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.78
|
| Rate for Payer: Healthscope Commercial |
$29.73
|
| Rate for Payer: Healthscope Whirlpool |
$28.84
|
| Rate for Payer: Mclaren Commercial |
$26.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.27
|
| Rate for Payer: Nomi Health Commercial |
$24.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.05
|
| Rate for Payer: Priority Health Narrow Network |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.16
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.97
|
|
|
Service Code
|
NDC 67457022899
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: ASR Commercial |
$28.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.61
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Whirlpool |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.38
|
|
|
Service Code
|
NDC 00409955849
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: Aetna Medicare |
$12.69
|
| Rate for Payer: ASR ASR |
$24.62
|
| Rate for Payer: ASR Commercial |
$24.62
|
| Rate for Payer: BCBS Complete |
$10.15
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Healthscope Commercial |
$25.38
|
| Rate for Payer: Healthscope Whirlpool |
$24.62
|
| Rate for Payer: Mclaren Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.57
|
| Rate for Payer: Nomi Health Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.24
|
| Rate for Payer: Priority Health Narrow Network |
$17.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.33
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 39822420002
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: ASR Commercial |
$23.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.63
|
| Rate for Payer: BCN Commercial |
$18.68
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$22.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Whirlpool |
$23.37
|
| Rate for Payer: Mclaren Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.78
|
|
|
Service Code
|
NDC 39822420006
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.81 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.50
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: ASR Commercial |
$22.10
|
| Rate for Payer: BCBS Trust/PPO |
$18.56
|
| Rate for Payer: BCN Commercial |
$17.66
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Whirlpool |
$22.10
|
| Rate for Payer: Mclaren Commercial |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.36
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
NDC 43066000710
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$21.60
|
| Rate for Payer: ASR ASR |
$23.28
|
| Rate for Payer: ASR Commercial |
$23.28
|
| Rate for Payer: BCBS Trust/PPO |
$19.56
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$22.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$24.00
|
| Rate for Payer: Healthscope Whirlpool |
$23.28
|
| Rate for Payer: Mclaren Commercial |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.40
|
| Rate for Payer: Nomi Health Commercial |
$19.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.12
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 67457022899
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: ASR Commercial |
$28.10
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Whirlpool |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.38
|
| Rate for Payer: Priority Health Narrow Network |
$20.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.33
|
|
|
Service Code
|
NDC 00409955850
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.73 |
| Max. Negotiated Rate |
$29.33 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: Aetna Medicare |
$14.66
|
| Rate for Payer: ASR ASR |
$28.45
|
| Rate for Payer: ASR Commercial |
$28.45
|
| Rate for Payer: BCBS Complete |
$11.73
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCN Commercial |
$22.74
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$27.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$29.33
|
| Rate for Payer: Healthscope Whirlpool |
$28.45
|
| Rate for Payer: Mclaren Commercial |
$26.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.70
|
| Rate for Payer: Priority Health Narrow Network |
$20.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.81
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$27.53
|
|
|
Service Code
|
NDC 55150022610
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.01 |
| Max. Negotiated Rate |
$27.53 |
| Rate for Payer: Aetna Commercial |
$24.78
|
| Rate for Payer: Aetna Medicare |
$13.76
|
| Rate for Payer: ASR ASR |
$26.70
|
| Rate for Payer: ASR Commercial |
$26.70
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS Trust/PPO |
$22.54
|
| Rate for Payer: BCN Commercial |
$21.34
|
| Rate for Payer: Cash Price |
$22.02
|
| Rate for Payer: Cofinity Commercial |
$25.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.02
|
| Rate for Payer: Healthscope Commercial |
$27.53
|
| Rate for Payer: Healthscope Whirlpool |
$26.70
|
| Rate for Payer: Mclaren Commercial |
$24.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.12
|
| Rate for Payer: Priority Health Narrow Network |
$19.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.23
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.38
|
|
|
Service Code
|
NDC 00409955869
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: ASR ASR |
$24.62
|
| Rate for Payer: ASR Commercial |
$24.62
|
| Rate for Payer: BCBS Trust/PPO |
$20.68
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Healthscope Commercial |
$25.38
|
| Rate for Payer: Healthscope Whirlpool |
$24.62
|
| Rate for Payer: Mclaren Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.57
|
| Rate for Payer: Nomi Health Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.33
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.97
|
|
|
Service Code
|
NDC 67457022810
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: ASR Commercial |
$28.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.61
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Whirlpool |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.83
|
|
|
Service Code
|
NDC 43066001310
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: Aetna Medicare |
$12.92
|
| Rate for Payer: ASR ASR |
$25.06
|
| Rate for Payer: ASR Commercial |
$25.06
|
| Rate for Payer: BCBS Complete |
$10.33
|
| Rate for Payer: BCBS Trust/PPO |
$21.15
|
| Rate for Payer: BCN Commercial |
$20.03
|
| Rate for Payer: Cash Price |
$20.66
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.66
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Healthscope Whirlpool |
$25.06
|
| Rate for Payer: Mclaren Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.96
|
| Rate for Payer: Nomi Health Commercial |
$21.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.63
|
| Rate for Payer: Priority Health Narrow Network |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.73
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.73
|
|
|
Service Code
|
NDC 72611075710
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$29.73 |
| Rate for Payer: Aetna Commercial |
$26.76
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: ASR ASR |
$28.84
|
| Rate for Payer: ASR Commercial |
$28.84
|
| Rate for Payer: BCBS Complete |
$11.89
|
| Rate for Payer: BCBS Trust/PPO |
$24.35
|
| Rate for Payer: BCN Commercial |
$23.05
|
| Rate for Payer: Cash Price |
$23.78
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.78
|
| Rate for Payer: Healthscope Commercial |
$29.73
|
| Rate for Payer: Healthscope Whirlpool |
$28.84
|
| Rate for Payer: Mclaren Commercial |
$26.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.27
|
| Rate for Payer: Nomi Health Commercial |
$24.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.05
|
| Rate for Payer: Priority Health Narrow Network |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.16
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.54
|
|
|
Service Code
|
NDC 25021066205
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$17.54 |
| Rate for Payer: Aetna Commercial |
$15.79
|
| Rate for Payer: Aetna Medicare |
$8.77
|
| Rate for Payer: ASR ASR |
$17.01
|
| Rate for Payer: ASR Commercial |
$17.01
|
| Rate for Payer: BCBS Complete |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.36
|
| Rate for Payer: BCN Commercial |
$13.60
|
| Rate for Payer: Cash Price |
$14.03
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$17.54
|
| Rate for Payer: Healthscope Whirlpool |
$17.01
|
| Rate for Payer: Mclaren Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.91
|
| Rate for Payer: Nomi Health Commercial |
$14.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.37
|
| Rate for Payer: Priority Health Narrow Network |
$12.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.44
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.49
|
|
|
Service Code
|
NDC 00409955805
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.87 |
| Max. Negotiated Rate |
$27.49 |
| Rate for Payer: Aetna Commercial |
$24.74
|
| Rate for Payer: ASR ASR |
$26.67
|
| Rate for Payer: ASR Commercial |
$26.67
|
| Rate for Payer: BCBS Trust/PPO |
$22.40
|
| Rate for Payer: BCN Commercial |
$21.31
|
| Rate for Payer: Cash Price |
$21.99
|
| Rate for Payer: Cofinity Commercial |
$25.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$27.49
|
| Rate for Payer: Healthscope Whirlpool |
$26.67
|
| Rate for Payer: Mclaren Commercial |
$24.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.37
|
| Rate for Payer: Nomi Health Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.19
|
|
|
ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25.83
|
|
|
Service Code
|
NDC 43066001310
|
| Hospital Charge Code |
12734
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.79 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: ASR ASR |
$25.06
|
| Rate for Payer: ASR Commercial |
$25.06
|
| Rate for Payer: BCBS Trust/PPO |
$21.05
|
| Rate for Payer: BCN Commercial |
$20.03
|
| Rate for Payer: Cash Price |
$20.66
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.66
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Healthscope Whirlpool |
$25.06
|
| Rate for Payer: Mclaren Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.96
|
| Rate for Payer: Nomi Health Commercial |
$21.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.73
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$27.49
|
|
|
Service Code
|
NDC 00409955805
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$27.49 |
| Rate for Payer: Aetna Commercial |
$24.74
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: ASR ASR |
$26.67
|
| Rate for Payer: ASR Commercial |
$26.67
|
| Rate for Payer: BCBS Complete |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$22.51
|
| Rate for Payer: BCN Commercial |
$21.31
|
| Rate for Payer: Cash Price |
$21.99
|
| Rate for Payer: Cofinity Commercial |
$25.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$27.49
|
| Rate for Payer: Healthscope Whirlpool |
$26.67
|
| Rate for Payer: Mclaren Commercial |
$24.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.37
|
| Rate for Payer: Nomi Health Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$19.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.19
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 39822420001
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$23.37
|
| Rate for Payer: ASR Commercial |
$23.37
|
| Rate for Payer: BCBS Trust/PPO |
$19.63
|
| Rate for Payer: BCN Commercial |
$18.68
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$22.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Whirlpool |
$23.37
|
| Rate for Payer: Mclaren Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$22.78
|
|
|
Service Code
|
NDC 39822420005
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.50
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: ASR Commercial |
$22.10
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$17.66
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Whirlpool |
$22.10
|
| Rate for Payer: Mclaren Commercial |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.36
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.96
|
| Rate for Payer: Priority Health Narrow Network |
$15.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 67457022810
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: ASR Commercial |
$28.10
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Whirlpool |
$28.10
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.38
|
| Rate for Payer: Priority Health Narrow Network |
$20.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$22.78
|
|
|
Service Code
|
NDC 39822420005
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.81 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.50
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: ASR Commercial |
$22.10
|
| Rate for Payer: BCBS Trust/PPO |
$18.56
|
| Rate for Payer: BCN Commercial |
$17.66
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Whirlpool |
$22.10
|
| Rate for Payer: Mclaren Commercial |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.36
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
