MANITOWOC CHARGE 10002800 AMIODARONE HCL IN DEXTROSE 360-4.14 MG/200ML-% IV SOLN Insurance and Self Pay Discounts 250 J0282 43066-360-20 $38.26

Aurora MANITOWOC
CHARGE
10002800
AMIODARONE HCL IN DEXTROSE 360-4.14 MG/200ML-% IV SOLN
Rev 250
CPT J0282
NDC 43066-360-20

Fee $38.26

Self-Pay $24.20

Insurance

Minimum $19.13
Maximum $32.52
Aetna W $19.12
Aetna PPO $31.91
Anthem Blue Priority $19.82
Anthem Blue Preferred $19.82
Anthem PPO $32.52
Aurora Caregiver $21.38
Centivo $22.71
Cigna GPPO $23.56
Cigna PPO $32.37
Common Ground ETF Network $22.49
Common Ground Exchange Envision $22.49
Common Ground Group Envision $22.49
Everpointe Elite $20.79
Health EOS Plus $23.33
Health EOS PPO $30.61
HealthPartners ETF $19.49
HealthPartners Robin Focused $22.77
HealthPartners Broad $28.69
HPS $22.66
HST $25.12
Humana HPN $22.70
Humana HMO $22.70
Humana PPO $32.37
Molina Exchange $23.61
Quartz One $19.13
Quartz Group $21.26
Trilogy $24.79
UHC Individual Exchange $22.28
UHC Charter $22.28
UHC Nexus $22.28
UHC HMO $24.84
UHC PPO $32.36
WPS Aurora Featured Network $22.99
WPS Arise $24.20
WPS Statewide $24.20