|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
IP
|
$3.14
|
|
|
Service Code
|
NDC 00378698501
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.04
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cofinity Advantage |
$2.20
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.51
|
| Rate for Payer: Healthscope Commercial |
$2.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.35
|
| Rate for Payer: PHP Commercial |
$2.67
|
| Rate for Payer: Priority Health SBD |
$1.98
|
|
|
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
41463
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: Aetna Commercial |
$22.52
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.85
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Advantage |
$34.30
|
| Rate for Payer: Cofinity Advantage |
$38.85
|
| Rate for Payer: Cofinity Advantage |
$23.45
|
| Rate for Payer: Cofinity Advantage |
$18.55
|
| Rate for Payer: Cofinity Advantage |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$22.79
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.40
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Healthscope Commercial |
$49.95
|
| Rate for Payer: Healthscope Commercial |
$23.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PHP Commercial |
$22.52
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: Priority Health SBD |
$30.87
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: Priority Health SBD |
$16.70
|
| Rate for Payer: Priority Health SBD |
$13.70
|
| Rate for Payer: Priority Health SBD |
$34.97
|
|
|
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION
|
Facility
|
OP
|
$26.50
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
41463
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$23.85 |
| Rate for Payer: Aetna Commercial |
$22.52
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Commercial |
$54.19
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Medicare |
$10.88
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Aetna Medicare |
$16.75
|
| Rate for Payer: Aetna Medicare |
$27.75
|
| Rate for Payer: Aetna Medicare |
$31.88
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: BCBS Complete |
$13.40
|
| Rate for Payer: BCBS Complete |
$25.50
|
| Rate for Payer: BCBS Complete |
$22.20
|
| Rate for Payer: BCBS Complete |
$10.60
|
| Rate for Payer: BCBS Complete |
$8.70
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cofinity Advantage |
$15.22
|
| Rate for Payer: Cofinity Advantage |
$38.85
|
| Rate for Payer: Cofinity Advantage |
$34.30
|
| Rate for Payer: Cofinity Advantage |
$44.62
|
| Rate for Payer: Cofinity Advantage |
$23.45
|
| Rate for Payer: Cofinity Advantage |
$18.55
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Commercial |
$22.79
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$54.83
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.40
|
| Rate for Payer: Healthscope Commercial |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$49.95
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Healthscope Commercial |
$23.85
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.81
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: PHP Commercial |
$22.52
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$54.19
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: Priority Health SBD |
$34.97
|
| Rate for Payer: Priority Health SBD |
$16.70
|
| Rate for Payer: Priority Health SBD |
$40.16
|
| Rate for Payer: Priority Health SBD |
$30.87
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: Priority Health SBD |
$13.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 1.5 MAINTENANCE SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180423
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 1.5 MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180423
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$43.07
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$36.61
|
| Rate for Payer: Aetna Medicare |
$21.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.00
|
| Rate for Payer: BCBS Complete |
$17.23
|
| Rate for Payer: Cash Price |
$34.46
|
| Rate for Payer: Cofinity Advantage |
$30.15
|
| Rate for Payer: Cofinity Commercial |
$37.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.46
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: Priority Health SBD |
$27.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.00
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: UHC Exchange |
$16.93
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$43.07
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.13 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$36.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.00
|
| Rate for Payer: Cash Price |
$34.46
|
| Rate for Payer: Cofinity Advantage |
$30.15
|
| Rate for Payer: Cofinity Commercial |
$37.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.46
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: Priority Health SBD |
$27.13
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$43.07
|
|
|
Service Code
|
NDC 338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$36.61
|
| Rate for Payer: Aetna Medicare |
$21.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.00
|
| Rate for Payer: BCBS Complete |
$17.23
|
| Rate for Payer: Cash Price |
$34.46
|
| Rate for Payer: Cofinity Advantage |
$30.15
|
| Rate for Payer: Cofinity Commercial |
$37.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.46
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: Priority Health SBD |
$27.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.00
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: UHC Exchange |
$16.93
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$67.19
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$53.63
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$43.87
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$25.24
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Advantage |
$61.41
|
| Rate for Payer: Cofinity Advantage |
$44.16
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Advantage |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$54.26
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Commercial |
$53.63
|
| Rate for Payer: Priority Health SBD |
$39.75
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$55.27
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Advantage |
$39.19
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: Priority Health SBD |
$40.19
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$63.80
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$1.65
|
| Rate for Payer: BCBS Trust/PPO |
$1.65
|
| Rate for Payer: BCN Commercial |
$1.65
|
| Rate for Payer: BCN Commercial |
$1.65
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Advantage |
$39.19
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.09
|
| Rate for Payer: UHC Core |
$1.09
|
| Rate for Payer: UHC Core |
$1.09
|
| Rate for Payer: UHC Exchange |
$1.09
|
| Rate for Payer: UHC Exchange |
$1.09
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.51 |
| Max. Negotiated Rate |
$56.44 |
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Commercial |
$39.32
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$55.21
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$51.96
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cash Price |
$37.01
|
| Rate for Payer: Cofinity Advantage |
$40.76
|
| Rate for Payer: Cofinity Advantage |
$45.47
|
| Rate for Payer: Cofinity Advantage |
$58.74
|
| Rate for Payer: Cofinity Advantage |
$32.38
|
| Rate for Payer: Cofinity Advantage |
$43.90
|
| Rate for Payer: Cofinity Advantage |
$37.62
|
| Rate for Payer: Cofinity Advantage |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$72.16
|
| Rate for Payer: Cofinity Commercial |
$39.78
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Cofinity Commercial |
$46.23
|
| Rate for Payer: Cofinity Commercial |
$55.86
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.01
|
| Rate for Payer: Healthscope Commercial |
$41.63
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$58.45
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.71
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$39.32
|
| Rate for Payer: PHP Commercial |
$55.21
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: Priority Health SBD |
$29.14
|
| Rate for Payer: Priority Health SBD |
$40.92
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$2.18
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Advantage |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$44.05
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$46.26
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$41.63 |
| Rate for Payer: Aetna Commercial |
$39.32
|
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: Aetna Commercial |
$55.21
|
| Rate for Payer: Aetna Commercial |
$66.44
|
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Aetna Medicare |
$1.73
|
| Rate for Payer: Aetna Medicare |
$23.13
|
| Rate for Payer: Aetna Medicare |
$26.88
|
| Rate for Payer: Aetna Medicare |
$41.95
|
| Rate for Payer: Aetna Medicare |
$39.08
|
| Rate for Payer: Aetna Medicare |
$32.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.22
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$31.26
|
| Rate for Payer: BCBS Complete |
$18.50
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.98
|
| Rate for Payer: BCBS Complete |
$1.38
|
| Rate for Payer: BCBS Complete |
$33.56
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$37.01
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$37.01
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$51.96
|
| Rate for Payer: Cash Price |
$51.96
|
| Rate for Payer: Cash Price |
$62.53
|
| Rate for Payer: Cash Price |
$62.53
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cofinity Advantage |
$2.42
|
| Rate for Payer: Cofinity Advantage |
$45.47
|
| Rate for Payer: Cofinity Advantage |
$37.62
|
| Rate for Payer: Cofinity Advantage |
$58.74
|
| Rate for Payer: Cofinity Advantage |
$32.38
|
| Rate for Payer: Cofinity Advantage |
$40.76
|
| Rate for Payer: Cofinity Advantage |
$43.90
|
| Rate for Payer: Cofinity Advantage |
$54.71
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$67.22
|
| Rate for Payer: Cofinity Commercial |
$72.16
|
| Rate for Payer: Cofinity Commercial |
$55.86
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Cofinity Commercial |
$39.78
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$46.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.96
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$58.45
|
| Rate for Payer: Healthscope Commercial |
$70.34
|
| Rate for Payer: Healthscope Commercial |
$41.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: PHP Commercial |
$39.32
|
| Rate for Payer: PHP Commercial |
$66.44
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Commercial |
$55.21
|
| Rate for Payer: Priority Health SBD |
$29.14
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: Priority Health SBD |
$40.92
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: Priority Health SBD |
$49.24
|
| Rate for Payer: Priority Health SBD |
$2.18
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$1.65
|
| Rate for Payer: BCN Commercial |
$1.65
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Advantage |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.09
|
| Rate for Payer: UHC Core |
$1.09
|
| Rate for Payer: UHC Exchange |
$1.09
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$63.09
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$56.78 |
| Rate for Payer: Aetna Commercial |
$53.63
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Complete |
$25.24
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Advantage |
$47.03
|
| Rate for Payer: Cofinity Advantage |
$44.16
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$54.26
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$53.63
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$39.75
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$83.91
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$75.52 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: Aetna Medicare |
$41.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Complete |
$33.56
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cofinity Advantage |
$58.74
|
| Rate for Payer: Cofinity Advantage |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$72.16
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.13
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION EKOS COOLANT LUMEN
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300184
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.28
|
| Rate for Payer: UHC Core |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION EKOS COOLANT LUMEN
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300184
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
OP
|
$83.91
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$75.52 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Medicare |
$41.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: BCBS Complete |
$33.56
|
| Rate for Payer: BCBS Trust/PPO |
$3.23
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cofinity Advantage |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$72.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.13
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.93
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.13
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Exchange |
$2.13
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$83.91
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.86 |
| Max. Negotiated Rate |
$75.52 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: Cash Price |
$67.13
|
| Rate for Payer: Cofinity Advantage |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$72.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.13
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.93
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: Priority Health SBD |
$52.86
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
NDC 00338004803
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
NDC 00338004803
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Advantage |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.45
|
| Rate for Payer: UHC Core |
$36.43
|
| Rate for Payer: UHC Exchange |
$27.48
|
|
