|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$40.10
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.08 |
| Max. Negotiated Rate |
$40.10 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: ASR ASR |
$38.90
|
| Rate for Payer: BCBS Trust/PPO |
$32.93
|
| Rate for Payer: BCN Commercial |
$32.93
|
| Rate for Payer: Cash Price |
$32.08
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.08
|
| Rate for Payer: Healthscope Commercial |
$38.90
|
| Rate for Payer: Healthscope Whirlpool |
$40.10
|
| Rate for Payer: Mclaren Commercial |
$36.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.09
|
| Rate for Payer: Nomi Health Commercial |
$32.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.29
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$30.92
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.19 |
| Max. Negotiated Rate |
$30.91 |
| Rate for Payer: Aetna Commercial |
$27.82
|
| Rate for Payer: ASR ASR |
$29.99
|
| Rate for Payer: BCBS Trust/PPO |
$25.39
|
| Rate for Payer: BCN Commercial |
$25.39
|
| Rate for Payer: Cash Price |
$24.73
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.73
|
| Rate for Payer: Healthscope Commercial |
$29.99
|
| Rate for Payer: Healthscope Whirlpool |
$30.91
|
| Rate for Payer: Mclaren Commercial |
$27.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Nomi Health Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.21
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$30.92
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$30.91 |
| Rate for Payer: Aetna Commercial |
$27.82
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: ASR ASR |
$29.99
|
| Rate for Payer: BCBS Complete |
$12.37
|
| Rate for Payer: BCBS Trust/PPO |
$25.49
|
| Rate for Payer: BCN Commercial |
$25.49
|
| Rate for Payer: Cash Price |
$24.73
|
| Rate for Payer: Cash Price |
$24.73
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.73
|
| Rate for Payer: Healthscope Commercial |
$29.99
|
| Rate for Payer: Healthscope Whirlpool |
$30.91
|
| Rate for Payer: Mclaren Commercial |
$27.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Nomi Health Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.21
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
OP
|
$55.93
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$55.93 |
| Rate for Payer: Aetna Commercial |
$50.34
|
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$15.89
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: ASR ASR |
$54.25
|
| Rate for Payer: ASR ASR |
$41.66
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$46.11
|
| Rate for Payer: BCBS Trust/PPO |
$35.41
|
| Rate for Payer: BCN Commercial |
$35.41
|
| Rate for Payer: BCN Commercial |
$46.11
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cofinity Commercial |
$40.37
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.36
|
| Rate for Payer: Healthscope Commercial |
$54.25
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Whirlpool |
$55.93
|
| Rate for Payer: Healthscope Whirlpool |
$42.95
|
| Rate for Payer: Mclaren Commercial |
$50.34
|
| Rate for Payer: Mclaren Commercial |
$38.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$35.22
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.22
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
IP
|
$42.95
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.21 |
| Max. Negotiated Rate |
$42.95 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Commercial |
$50.34
|
| Rate for Payer: ASR ASR |
$54.25
|
| Rate for Payer: ASR ASR |
$41.66
|
| Rate for Payer: BCBS Trust/PPO |
$45.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.27
|
| Rate for Payer: BCN Commercial |
$45.93
|
| Rate for Payer: BCN Commercial |
$35.27
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cofinity Commercial |
$40.37
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.36
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Commercial |
$54.25
|
| Rate for Payer: Healthscope Whirlpool |
$55.93
|
| Rate for Payer: Healthscope Whirlpool |
$42.95
|
| Rate for Payer: Mclaren Commercial |
$50.34
|
| Rate for Payer: Mclaren Commercial |
$38.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.51
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Nomi Health Commercial |
$35.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.22
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.93
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.95 |
| Max. Negotiated Rate |
$55.93 |
| Rate for Payer: Aetna Commercial |
$50.34
|
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Commercial |
$109.48
|
| Rate for Payer: Aetna Commercial |
$41.53
|
| Rate for Payer: ASR ASR |
$44.76
|
| Rate for Payer: ASR ASR |
$118.00
|
| Rate for Payer: ASR ASR |
$41.66
|
| Rate for Payer: ASR ASR |
$54.25
|
| Rate for Payer: BCBS Trust/PPO |
$45.93
|
| Rate for Payer: BCBS Trust/PPO |
$99.90
|
| Rate for Payer: BCBS Trust/PPO |
$37.89
|
| Rate for Payer: BCBS Trust/PPO |
$35.27
|
| Rate for Payer: BCN Commercial |
$37.89
|
| Rate for Payer: BCN Commercial |
$99.90
|
| Rate for Payer: BCN Commercial |
$45.93
|
| Rate for Payer: BCN Commercial |
$35.27
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$36.91
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$114.35
|
| Rate for Payer: Cofinity Commercial |
$40.37
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$118.00
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Commercial |
$54.25
|
| Rate for Payer: Healthscope Commercial |
$44.76
|
| Rate for Payer: Healthscope Whirlpool |
$42.95
|
| Rate for Payer: Healthscope Whirlpool |
$46.14
|
| Rate for Payer: Healthscope Whirlpool |
$55.93
|
| Rate for Payer: Healthscope Whirlpool |
$121.65
|
| Rate for Payer: Mclaren Commercial |
$41.53
|
| Rate for Payer: Mclaren Commercial |
$38.66
|
| Rate for Payer: Mclaren Commercial |
$50.34
|
| Rate for Payer: Mclaren Commercial |
$109.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$99.75
|
| Rate for Payer: Nomi Health Commercial |
$37.84
|
| Rate for Payer: Nomi Health Commercial |
$35.22
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.22
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$55.93
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$55.93 |
| Rate for Payer: Aetna Commercial |
$50.34
|
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Commercial |
$41.53
|
| Rate for Payer: Aetna Commercial |
$109.48
|
| Rate for Payer: Aetna Medicare |
$45.01
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Aetna Medicare |
$17.07
|
| Rate for Payer: Aetna Medicare |
$15.89
|
| Rate for Payer: ASR ASR |
$44.76
|
| Rate for Payer: ASR ASR |
$41.66
|
| Rate for Payer: ASR ASR |
$118.00
|
| Rate for Payer: ASR ASR |
$54.25
|
| Rate for Payer: BCBS Complete |
$18.46
|
| Rate for Payer: BCBS Complete |
$48.66
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Trust/PPO |
$35.41
|
| Rate for Payer: BCBS Trust/PPO |
$46.11
|
| Rate for Payer: BCBS Trust/PPO |
$38.04
|
| Rate for Payer: BCBS Trust/PPO |
$100.30
|
| Rate for Payer: BCN Commercial |
$46.11
|
| Rate for Payer: BCN Commercial |
$38.04
|
| Rate for Payer: BCN Commercial |
$100.30
|
| Rate for Payer: BCN Commercial |
$35.41
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$36.91
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cash Price |
$34.36
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$36.91
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$114.35
|
| Rate for Payer: Cofinity Commercial |
$43.37
|
| Rate for Payer: Cofinity Commercial |
$40.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.91
|
| Rate for Payer: Healthscope Commercial |
$54.25
|
| Rate for Payer: Healthscope Commercial |
$118.00
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Commercial |
$44.76
|
| Rate for Payer: Healthscope Whirlpool |
$121.65
|
| Rate for Payer: Healthscope Whirlpool |
$46.14
|
| Rate for Payer: Healthscope Whirlpool |
$55.93
|
| Rate for Payer: Healthscope Whirlpool |
$42.95
|
| Rate for Payer: Mclaren Commercial |
$41.53
|
| Rate for Payer: Mclaren Commercial |
$38.66
|
| Rate for Payer: Mclaren Commercial |
$109.48
|
| Rate for Payer: Mclaren Commercial |
$50.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$99.75
|
| Rate for Payer: Nomi Health Commercial |
$37.84
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Nomi Health Commercial |
$35.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.80
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$341.04
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$341.04 |
| Rate for Payer: Aetna Commercial |
$306.94
|
| Rate for Payer: Aetna Medicare |
$1.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.91
|
| Rate for Payer: ASR ASR |
$330.81
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: BCBS MAPPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$281.19
|
| Rate for Payer: BCN Commercial |
$281.19
|
| Rate for Payer: BCN Medicare Advantage |
$1.53
|
| Rate for Payer: Cash Price |
$272.83
|
| Rate for Payer: Cash Price |
$272.83
|
| Rate for Payer: Cofinity Commercial |
$320.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.53
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Healthscope Whirlpool |
$341.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$1.53
|
| Rate for Payer: Mclaren Commercial |
$306.94
|
| Rate for Payer: Mclaren Medicaid |
$1.53
|
| Rate for Payer: Mclaren Medicare |
$1.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.61
|
| Rate for Payer: Meridian Medicaid |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.88
|
| Rate for Payer: Nomi Health Commercial |
$279.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.78
|
| Rate for Payer: PACE Medicare |
$1.45
|
| Rate for Payer: PACE SWMI |
$1.53
|
| Rate for Payer: PHP Commercial |
$1.68
|
| Rate for Payer: PHP Medicaid |
$0.82
|
| Rate for Payer: PHP Medicare Advantage |
$1.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.31
|
| Rate for Payer: Priority Health Medicare |
$1.53
|
| Rate for Payer: Priority Health Narrow Network |
$1.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.53
|
| Rate for Payer: UHC Exchange |
$2.37
|
| Rate for Payer: UHC Medicaid |
$0.80
|
| Rate for Payer: UHCCP DNSP |
$1.53
|
| Rate for Payer: UHCCP Medicaid |
$0.80
|
| Rate for Payer: VA VA |
$1.53
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$180.96
|
|
|
Service Code
|
HCPCS J2596
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$135.72 |
| Max. Negotiated Rate |
$180.96 |
| Rate for Payer: Aetna Commercial |
$162.86
|
| Rate for Payer: ASR ASR |
$175.53
|
| Rate for Payer: BCBS Trust/PPO |
$148.60
|
| Rate for Payer: BCN Commercial |
$148.60
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Healthscope Commercial |
$175.53
|
| Rate for Payer: Healthscope Whirlpool |
$180.96
|
| Rate for Payer: Mclaren Commercial |
$162.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.82
|
| Rate for Payer: Nomi Health Commercial |
$148.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.24
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$341.04
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$255.78 |
| Max. Negotiated Rate |
$341.04 |
| Rate for Payer: Aetna Commercial |
$306.94
|
| Rate for Payer: ASR ASR |
$330.81
|
| Rate for Payer: BCBS Trust/PPO |
$280.06
|
| Rate for Payer: BCN Commercial |
$280.06
|
| Rate for Payer: Cash Price |
$272.83
|
| Rate for Payer: Cofinity Commercial |
$320.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.83
|
| Rate for Payer: Healthscope Commercial |
$330.81
|
| Rate for Payer: Healthscope Whirlpool |
$341.04
|
| Rate for Payer: Mclaren Commercial |
$306.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.88
|
| Rate for Payer: Nomi Health Commercial |
$279.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.12
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$180.96
|
|
|
Service Code
|
HCPCS J2596
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$180.96 |
| Rate for Payer: Aetna Commercial |
$162.86
|
| Rate for Payer: Aetna Medicare |
$66.96
|
| Rate for Payer: ASR ASR |
$175.53
|
| Rate for Payer: BCBS Complete |
$72.38
|
| Rate for Payer: BCBS Trust/PPO |
$149.20
|
| Rate for Payer: BCN Commercial |
$149.20
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Healthscope Commercial |
$175.53
|
| Rate for Payer: Healthscope Whirlpool |
$180.96
|
| Rate for Payer: Mclaren Commercial |
$162.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.82
|
| Rate for Payer: Nomi Health Commercial |
$148.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.86
|
| Rate for Payer: Priority Health Narrow Network |
$1.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.24
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26,282.62
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19,711.97 |
| Max. Negotiated Rate |
$26,282.62 |
| Rate for Payer: Aetna Commercial |
$23,654.36
|
| Rate for Payer: ASR ASR |
$25,494.14
|
| Rate for Payer: BCBS Trust/PPO |
$21,583.29
|
| Rate for Payer: BCN Commercial |
$21,583.29
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cofinity Commercial |
$24,705.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,026.10
|
| Rate for Payer: Healthscope Commercial |
$25,494.14
|
| Rate for Payer: Healthscope Whirlpool |
$26,282.62
|
| Rate for Payer: Mclaren Commercial |
$23,654.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,340.23
|
| Rate for Payer: Nomi Health Commercial |
$21,551.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,711.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,128.71
|
|
|
VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26,282.62
|
|
|
Service Code
|
HCPCS J3380
|
| Hospital Charge Code |
170876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$26,282.62 |
| Rate for Payer: Aetna Commercial |
$23,654.36
|
| Rate for Payer: Aetna Medicare |
$20.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.23
|
| Rate for Payer: ASR ASR |
$25,494.14
|
| Rate for Payer: BCBS Complete |
$11.52
|
| Rate for Payer: BCBS MAPPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$21,670.02
|
| Rate for Payer: BCN Commercial |
$21,670.02
|
| Rate for Payer: BCN Medicare Advantage |
$20.98
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cash Price |
$21,026.10
|
| Rate for Payer: Cofinity Commercial |
$24,705.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,026.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.98
|
| Rate for Payer: Healthscope Commercial |
$25,494.14
|
| Rate for Payer: Healthscope Whirlpool |
$26,282.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.98
|
| Rate for Payer: Mclaren Commercial |
$23,654.36
|
| Rate for Payer: Mclaren Medicaid |
$20.98
|
| Rate for Payer: Mclaren Medicare |
$20.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.03
|
| Rate for Payer: Meridian Medicaid |
$11.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,340.23
|
| Rate for Payer: Nomi Health Commercial |
$21,551.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19,711.97
|
| Rate for Payer: PACE Medicare |
$19.93
|
| Rate for Payer: PACE SWMI |
$20.98
|
| Rate for Payer: PHP Commercial |
$23.08
|
| Rate for Payer: PHP Medicaid |
$11.25
|
| Rate for Payer: PHP Medicare Advantage |
$20.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$20.98
|
| Rate for Payer: Priority Health Narrow Network |
$17.74
|
| Rate for Payer: Railroad Medicare Medicare |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,128.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.98
|
| Rate for Payer: UHC Exchange |
$32.52
|
| Rate for Payer: UHC Medicaid |
$10.97
|
| Rate for Payer: UHCCP DNSP |
$20.98
|
| Rate for Payer: UHCCP Medicaid |
$10.97
|
| Rate for Payer: VA VA |
$20.98
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$42,005.01
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$22,582.96 |
| Max. Negotiated Rate |
$42,005.01 |
| Rate for Payer: Aetna Medicare |
$23,771.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,714.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,714.42
|
| Rate for Payer: BCBS MAPPO |
$23,771.54
|
| Rate for Payer: BCN Medicare Advantage |
$23,771.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,771.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,771.54
|
| Rate for Payer: Mclaren Medicare |
$23,771.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,960.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,337.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$26,148.69
|
| Rate for Payer: PACE Medicare |
$22,582.96
|
| Rate for Payer: PACE SWMI |
$23,771.54
|
| Rate for Payer: PHP Commercial |
$26,148.69
|
| Rate for Payer: PHP Medicare Advantage |
$23,771.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42,005.01
|
| Rate for Payer: Priority Health Medicare |
$23,771.54
|
| Rate for Payer: Priority Health Narrow Network |
$33,604.01
|
| Rate for Payer: Railroad Medicare Medicare |
$23,771.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23,771.54
|
| Rate for Payer: UHC Exchange |
$36,845.89
|
| Rate for Payer: UHCCP DNSP |
$23,771.54
|
| Rate for Payer: VA VA |
$23,771.54
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$264.96
|
|
|
Service Code
|
NDC 51079048020
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$198.72 |
| Max. Negotiated Rate |
$264.96 |
| Rate for Payer: Aetna Commercial |
$238.46
|
| Rate for Payer: ASR ASR |
$257.01
|
| Rate for Payer: BCBS Trust/PPO |
$217.59
|
| Rate for Payer: BCN Commercial |
$217.59
|
| Rate for Payer: Cash Price |
$211.97
|
| Rate for Payer: Cofinity Commercial |
$249.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.97
|
| Rate for Payer: Healthscope Commercial |
$257.01
|
| Rate for Payer: Healthscope Whirlpool |
$264.96
|
| Rate for Payer: Mclaren Commercial |
$238.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.22
|
| Rate for Payer: Nomi Health Commercial |
$217.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.16
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$4.40
|
|
|
Service Code
|
NDC 68084084411
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$4.40 |
| Rate for Payer: Aetna Commercial |
$3.96
|
| Rate for Payer: Aetna Medicare |
$1.63
|
| Rate for Payer: ASR ASR |
$4.27
|
| Rate for Payer: BCBS Complete |
$1.76
|
| Rate for Payer: BCBS Trust/PPO |
$3.63
|
| Rate for Payer: BCN Commercial |
$3.63
|
| Rate for Payer: Cash Price |
$3.52
|
| Rate for Payer: Cofinity Commercial |
$4.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$4.27
|
| Rate for Payer: Healthscope Whirlpool |
$4.40
|
| Rate for Payer: Mclaren Commercial |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.74
|
| Rate for Payer: Nomi Health Commercial |
$3.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.85
|
| Rate for Payer: Priority Health Narrow Network |
$3.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.87
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$439.68
|
|
|
Service Code
|
NDC 68084084401
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$329.76 |
| Max. Negotiated Rate |
$439.68 |
| Rate for Payer: Aetna Commercial |
$395.71
|
| Rate for Payer: ASR ASR |
$426.49
|
| Rate for Payer: BCBS Trust/PPO |
$361.07
|
| Rate for Payer: BCN Commercial |
$361.07
|
| Rate for Payer: Cash Price |
$351.74
|
| Rate for Payer: Cofinity Commercial |
$413.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.74
|
| Rate for Payer: Healthscope Commercial |
$426.49
|
| Rate for Payer: Healthscope Whirlpool |
$439.68
|
| Rate for Payer: Mclaren Commercial |
$395.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.73
|
| Rate for Payer: Nomi Health Commercial |
$360.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.92
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$264.96
|
|
|
Service Code
|
NDC 51079048020
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.04 |
| Max. Negotiated Rate |
$264.96 |
| Rate for Payer: Aetna Commercial |
$238.46
|
| Rate for Payer: Aetna Medicare |
$98.04
|
| Rate for Payer: ASR ASR |
$257.01
|
| Rate for Payer: BCBS Complete |
$105.98
|
| Rate for Payer: BCBS Trust/PPO |
$218.46
|
| Rate for Payer: BCN Commercial |
$218.46
|
| Rate for Payer: Cash Price |
$211.97
|
| Rate for Payer: Cofinity Commercial |
$249.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.97
|
| Rate for Payer: Healthscope Commercial |
$257.01
|
| Rate for Payer: Healthscope Whirlpool |
$264.96
|
| Rate for Payer: Mclaren Commercial |
$238.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.22
|
| Rate for Payer: Nomi Health Commercial |
$217.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.16
|
| Rate for Payer: Priority Health Narrow Network |
$185.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.16
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$291.65
|
|
|
Service Code
|
NDC 68382001901
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna Commercial |
$262.49
|
| Rate for Payer: Aetna Medicare |
$107.91
|
| Rate for Payer: ASR ASR |
$282.90
|
| Rate for Payer: BCBS Complete |
$116.66
|
| Rate for Payer: BCBS Trust/PPO |
$240.47
|
| Rate for Payer: BCN Commercial |
$240.47
|
| Rate for Payer: Cash Price |
$233.32
|
| Rate for Payer: Cofinity Commercial |
$274.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.32
|
| Rate for Payer: Healthscope Commercial |
$282.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.65
|
| Rate for Payer: Mclaren Commercial |
$262.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.90
|
| Rate for Payer: Nomi Health Commercial |
$239.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$255.54
|
| Rate for Payer: Priority Health Narrow Network |
$204.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.65
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$4.40
|
|
|
Service Code
|
NDC 68084084411
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$4.40 |
| Rate for Payer: Aetna Commercial |
$3.96
|
| Rate for Payer: ASR ASR |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$3.61
|
| Rate for Payer: BCN Commercial |
$3.61
|
| Rate for Payer: Cash Price |
$3.52
|
| Rate for Payer: Cofinity Commercial |
$4.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$4.27
|
| Rate for Payer: Healthscope Whirlpool |
$4.40
|
| Rate for Payer: Mclaren Commercial |
$3.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.74
|
| Rate for Payer: Nomi Health Commercial |
$3.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.87
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna Commercial |
$2.38
|
| Rate for Payer: Aetna Medicare |
$0.98
|
| Rate for Payer: ASR ASR |
$2.57
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: BCBS Trust/PPO |
$2.18
|
| Rate for Payer: BCN Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.57
|
| Rate for Payer: Healthscope Whirlpool |
$2.65
|
| Rate for Payer: Mclaren Commercial |
$2.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.32
|
| Rate for Payer: Priority Health Narrow Network |
$1.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.33
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
OP
|
$439.68
|
|
|
Service Code
|
NDC 68084084401
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.68 |
| Max. Negotiated Rate |
$439.68 |
| Rate for Payer: Aetna Commercial |
$395.71
|
| Rate for Payer: Aetna Medicare |
$162.68
|
| Rate for Payer: ASR ASR |
$426.49
|
| Rate for Payer: BCBS Complete |
$175.87
|
| Rate for Payer: BCBS Trust/PPO |
$362.52
|
| Rate for Payer: BCN Commercial |
$362.52
|
| Rate for Payer: Cash Price |
$351.74
|
| Rate for Payer: Cofinity Commercial |
$413.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.74
|
| Rate for Payer: Healthscope Commercial |
$426.49
|
| Rate for Payer: Healthscope Whirlpool |
$439.68
|
| Rate for Payer: Mclaren Commercial |
$395.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.73
|
| Rate for Payer: Nomi Health Commercial |
$360.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$385.25
|
| Rate for Payer: Priority Health Narrow Network |
$308.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.92
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$291.65
|
|
|
Service Code
|
NDC 68382001901
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$218.74 |
| Max. Negotiated Rate |
$291.65 |
| Rate for Payer: Aetna Commercial |
$262.49
|
| Rate for Payer: ASR ASR |
$282.90
|
| Rate for Payer: BCBS Trust/PPO |
$239.50
|
| Rate for Payer: BCN Commercial |
$239.50
|
| Rate for Payer: Cash Price |
$233.32
|
| Rate for Payer: Cofinity Commercial |
$274.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.32
|
| Rate for Payer: Healthscope Commercial |
$282.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.65
|
| Rate for Payer: Mclaren Commercial |
$262.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.90
|
| Rate for Payer: Nomi Health Commercial |
$239.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.65
|
|
|
VENLAFAXINE 37.5 MG TABLET
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
NDC 51079048001
|
| Hospital Charge Code |
12207
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna Commercial |
$2.38
|
| Rate for Payer: ASR ASR |
$2.57
|
| Rate for Payer: BCBS Trust/PPO |
$2.18
|
| Rate for Payer: BCN Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.57
|
| Rate for Payer: Healthscope Whirlpool |
$2.65
|
| Rate for Payer: Mclaren Commercial |
$2.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Nomi Health Commercial |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.33
|
|
|
VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$173.43
|
|
|
Service Code
|
NDC 65862052790
|
| Hospital Charge Code |
27857
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.17 |
| Max. Negotiated Rate |
$173.43 |
| Rate for Payer: Aetna Commercial |
$156.09
|
| Rate for Payer: Aetna Medicare |
$64.17
|
| Rate for Payer: ASR ASR |
$168.23
|
| Rate for Payer: BCBS Complete |
$69.37
|
| Rate for Payer: BCBS Trust/PPO |
$142.99
|
| Rate for Payer: BCN Commercial |
$142.99
|
| Rate for Payer: Cash Price |
$138.74
|
| Rate for Payer: Cofinity Commercial |
$163.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.74
|
| Rate for Payer: Healthscope Commercial |
$168.23
|
| Rate for Payer: Healthscope Whirlpool |
$173.43
|
| Rate for Payer: Mclaren Commercial |
$156.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.42
|
| Rate for Payer: Nomi Health Commercial |
$142.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$151.96
|
| Rate for Payer: Priority Health Narrow Network |
$121.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.62
|
|
