|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$29.82
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna Medicare |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.78
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$29.82
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.79 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: Priority Health SBD |
$18.79
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$29.82
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.79 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$21.03
|
|
|
Service Code
|
NDC 09900000157
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$18.93 |
| Rate for Payer: Aetna Commercial |
$17.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.67
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cofinity Advantage |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.77
|
| Rate for Payer: PHP Commercial |
$17.88
|
| Rate for Payer: Priority Health SBD |
$13.25
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$29.82
|
|
|
Service Code
|
NDC 00781328909
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Medicare |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$15.54
|
| Rate for Payer: UHC Exchange |
$11.72
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.78
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.88
|
| Rate for Payer: UHC Core |
$11.13
|
| Rate for Payer: UHC Exchange |
$8.39
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$29.82
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Medicare |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$15.54
|
| Rate for Payer: UHC Exchange |
$11.72
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$21.03
|
|
|
Service Code
|
NDC 09900000157
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$18.93 |
| Rate for Payer: Aetna Commercial |
$17.88
|
| Rate for Payer: Aetna Medicare |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.67
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cofinity Advantage |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.77
|
| Rate for Payer: PHP Commercial |
$17.88
|
| Rate for Payer: Priority Health SBD |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.67
|
| Rate for Payer: UHC Core |
$10.96
|
| Rate for Payer: UHC Exchange |
$8.26
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$29.82
|
|
|
Service Code
|
NDC 00781328909
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.79 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$441.80
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$278.33 |
| Max. Negotiated Rate |
$397.62 |
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cofinity Advantage |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.35
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: Priority Health SBD |
$278.33
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$441.80
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.63 |
| Max. Negotiated Rate |
$397.62 |
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna Medicare |
$220.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: BCBS Complete |
$176.72
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cofinity Advantage |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.35
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: Priority Health SBD |
$278.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.17
|
| Rate for Payer: UHC Core |
$230.18
|
| Rate for Payer: UHC Exchange |
$173.63
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$365.75
|
|
|
Service Code
|
NDC 59762001601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.74 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna Medicare |
$182.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.74
|
| Rate for Payer: BCBS Complete |
$146.30
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Advantage |
$256.02
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: Priority Health SBD |
$230.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.74
|
| Rate for Payer: UHC Core |
$190.56
|
| Rate for Payer: UHC Exchange |
$143.74
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$408.90
|
|
|
Service Code
|
NDC 64980051110
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$160.70 |
| Max. Negotiated Rate |
$368.01 |
| Rate for Payer: Aetna Commercial |
$347.56
|
| Rate for Payer: Aetna Medicare |
$204.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.79
|
| Rate for Payer: BCBS Complete |
$163.56
|
| Rate for Payer: Cash Price |
$327.12
|
| Rate for Payer: Cofinity Advantage |
$286.23
|
| Rate for Payer: Cofinity Commercial |
$351.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.12
|
| Rate for Payer: Healthscope Commercial |
$368.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.68
|
| Rate for Payer: PHP Commercial |
$347.56
|
| Rate for Payer: Priority Health SBD |
$257.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.79
|
| Rate for Payer: UHC Core |
$213.04
|
| Rate for Payer: UHC Exchange |
$160.70
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$416.10
|
|
|
Service Code
|
NDC 65862059602
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$262.14 |
| Max. Negotiated Rate |
$374.49 |
| Rate for Payer: Aetna Commercial |
$353.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.46
|
| Rate for Payer: Cash Price |
$332.88
|
| Rate for Payer: Cofinity Advantage |
$291.27
|
| Rate for Payer: Cofinity Commercial |
$357.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.88
|
| Rate for Payer: Healthscope Commercial |
$374.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.07
|
| Rate for Payer: PHP Commercial |
$353.69
|
| Rate for Payer: Priority Health SBD |
$262.14
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$365.75
|
|
|
Service Code
|
NDC 59762001601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$230.42 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.74
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Advantage |
$256.02
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: Priority Health SBD |
$230.42
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$408.90
|
|
|
Service Code
|
NDC 64980051110
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$257.61 |
| Max. Negotiated Rate |
$368.01 |
| Rate for Payer: Aetna Commercial |
$347.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.79
|
| Rate for Payer: Cash Price |
$327.12
|
| Rate for Payer: Cofinity Advantage |
$286.23
|
| Rate for Payer: Cofinity Commercial |
$351.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.12
|
| Rate for Payer: Healthscope Commercial |
$368.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.68
|
| Rate for Payer: PHP Commercial |
$347.56
|
| Rate for Payer: Priority Health SBD |
$257.61
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$416.10
|
|
|
Service Code
|
NDC 65862059602
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$374.49 |
| Rate for Payer: Aetna Commercial |
$353.69
|
| Rate for Payer: Aetna Medicare |
$208.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.46
|
| Rate for Payer: BCBS Complete |
$166.44
|
| Rate for Payer: Cash Price |
$332.88
|
| Rate for Payer: Cofinity Advantage |
$291.27
|
| Rate for Payer: Cofinity Commercial |
$357.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.88
|
| Rate for Payer: Healthscope Commercial |
$374.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.07
|
| Rate for Payer: PHP Commercial |
$353.69
|
| Rate for Payer: Priority Health SBD |
$262.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.46
|
| Rate for Payer: UHC Core |
$216.79
|
| Rate for Payer: UHC Exchange |
$163.53
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$26.48
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.68 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Advantage |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health SBD |
$16.68
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$54.29
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$34.20 |
| Max. Negotiated Rate |
$48.86 |
| Rate for Payer: Aetna Commercial |
$46.15
|
| Rate for Payer: Aetna Commercial |
$13.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.58
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$43.43
|
| Rate for Payer: Cofinity Advantage |
$38.00
|
| Rate for Payer: Cofinity Advantage |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$46.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.02
|
| Rate for Payer: Healthscope Commercial |
$48.86
|
| Rate for Payer: Healthscope Commercial |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.72
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: PHP Commercial |
$46.15
|
| Rate for Payer: Priority Health SBD |
$34.20
|
| Rate for Payer: Priority Health SBD |
$10.26
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$16.28
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$14.65 |
| Rate for Payer: Aetna Commercial |
$13.84
|
| Rate for Payer: Aetna Commercial |
$46.15
|
| Rate for Payer: Aetna Medicare |
$27.14
|
| Rate for Payer: Aetna Medicare |
$8.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.29
|
| Rate for Payer: BCBS Complete |
$21.72
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.78
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$43.43
|
| Rate for Payer: Cash Price |
$43.43
|
| Rate for Payer: Cofinity Advantage |
$11.40
|
| Rate for Payer: Cofinity Advantage |
$38.00
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$46.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.02
|
| Rate for Payer: Healthscope Commercial |
$48.86
|
| Rate for Payer: Healthscope Commercial |
$14.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.72
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: PHP Commercial |
$46.15
|
| Rate for Payer: Priority Health SBD |
$10.26
|
| Rate for Payer: Priority Health SBD |
$34.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.58
|
| Rate for Payer: UHC Core |
$8.48
|
| Rate for Payer: UHC Core |
$28.29
|
| Rate for Payer: UHC Exchange |
$6.40
|
| Rate for Payer: UHC Exchange |
$21.34
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$26.48
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$5.89
|
| Rate for Payer: BCN Commercial |
$5.89
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Advantage |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.21
|
| Rate for Payer: UHC Core |
$13.80
|
| Rate for Payer: UHC Exchange |
$10.41
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$4.54
|
|
|
Service Code
|
NDC 42292001801
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna Commercial |
$3.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.95
|
| Rate for Payer: Cash Price |
$3.63
|
| Rate for Payer: Cofinity Advantage |
$3.18
|
| Rate for Payer: Cofinity Commercial |
$3.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.63
|
| Rate for Payer: Healthscope Commercial |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.40
|
| Rate for Payer: PHP Commercial |
$3.86
|
| Rate for Payer: Priority Health SBD |
$2.86
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$2.17
|
|
|
Service Code
|
NDC 68084024311
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.37 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.41
|
| Rate for Payer: Cash Price |
$1.74
|
| Rate for Payer: Cofinity Advantage |
$1.52
|
| Rate for Payer: Cofinity Commercial |
$1.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.74
|
| Rate for Payer: Healthscope Commercial |
$1.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.63
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: Priority Health SBD |
$1.37
|
|
