|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$265.05
|
|
|
Service Code
|
NDC 00378581377
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$166.98 |
| Max. Negotiated Rate |
$238.54 |
| Rate for Payer: Aetna Commercial |
$225.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.28
|
| Rate for Payer: Cash Price |
$212.04
|
| Rate for Payer: Cofinity Advantage |
$185.53
|
| Rate for Payer: Cofinity Commercial |
$227.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.04
|
| Rate for Payer: Healthscope Commercial |
$238.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.79
|
| Rate for Payer: PHP Commercial |
$225.29
|
| Rate for Payer: Priority Health SBD |
$166.98
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$3,022.31
|
|
|
Service Code
|
NDC 00078035834
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,904.06 |
| Max. Negotiated Rate |
$2,720.08 |
| Rate for Payer: Aetna Commercial |
$2,568.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.50
|
| Rate for Payer: Cash Price |
$2,417.85
|
| Rate for Payer: Cofinity Advantage |
$2,115.62
|
| Rate for Payer: Cofinity Commercial |
$2,599.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.85
|
| Rate for Payer: Healthscope Commercial |
$2,720.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.73
|
| Rate for Payer: PHP Commercial |
$2,568.96
|
| Rate for Payer: Priority Health SBD |
$1,904.06
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$516.96
|
|
|
Service Code
|
NDC 60687062301
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$465.26 |
| Rate for Payer: Aetna Commercial |
$439.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.02
|
| Rate for Payer: Cash Price |
$413.57
|
| Rate for Payer: Cofinity Advantage |
$361.87
|
| Rate for Payer: Cofinity Commercial |
$444.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.57
|
| Rate for Payer: Healthscope Commercial |
$465.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.72
|
| Rate for Payer: PHP Commercial |
$439.42
|
| Rate for Payer: Priority Health SBD |
$325.68
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$516.96
|
|
|
Service Code
|
NDC 60687062301
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$203.17 |
| Max. Negotiated Rate |
$465.26 |
| Rate for Payer: Aetna Commercial |
$439.42
|
| Rate for Payer: Aetna Medicare |
$258.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.02
|
| Rate for Payer: BCBS Complete |
$206.78
|
| Rate for Payer: Cash Price |
$413.57
|
| Rate for Payer: Cofinity Advantage |
$361.87
|
| Rate for Payer: Cofinity Commercial |
$444.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.57
|
| Rate for Payer: Healthscope Commercial |
$465.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.72
|
| Rate for Payer: PHP Commercial |
$439.42
|
| Rate for Payer: Priority Health SBD |
$325.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.02
|
| Rate for Payer: UHC Core |
$269.34
|
| Rate for Payer: UHC Exchange |
$203.17
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$265.05
|
|
|
Service Code
|
NDC 00378581377
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$238.54 |
| Rate for Payer: Aetna Commercial |
$225.29
|
| Rate for Payer: Aetna Medicare |
$132.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.28
|
| Rate for Payer: BCBS Complete |
$106.02
|
| Rate for Payer: Cash Price |
$212.04
|
| Rate for Payer: Cofinity Advantage |
$185.53
|
| Rate for Payer: Cofinity Commercial |
$227.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.04
|
| Rate for Payer: Healthscope Commercial |
$238.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.79
|
| Rate for Payer: PHP Commercial |
$225.29
|
| Rate for Payer: Priority Health SBD |
$166.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.28
|
| Rate for Payer: UHC Core |
$138.09
|
| Rate for Payer: UHC Exchange |
$104.16
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$5.17
|
|
|
Service Code
|
NDC 60687062311
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$4.65 |
| Rate for Payer: Aetna Commercial |
$4.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.36
|
| Rate for Payer: Cash Price |
$4.14
|
| Rate for Payer: Cofinity Advantage |
$3.62
|
| Rate for Payer: Cofinity Commercial |
$4.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.14
|
| Rate for Payer: Healthscope Commercial |
$4.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.88
|
| Rate for Payer: PHP Commercial |
$4.39
|
| Rate for Payer: Priority Health SBD |
$3.26
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$3,022.31
|
|
|
Service Code
|
NDC 00078035834
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,187.77 |
| Max. Negotiated Rate |
$2,720.08 |
| Rate for Payer: Aetna Commercial |
$2,568.96
|
| Rate for Payer: Aetna Medicare |
$1,511.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.50
|
| Rate for Payer: BCBS Complete |
$1,208.92
|
| Rate for Payer: Cash Price |
$2,417.85
|
| Rate for Payer: Cofinity Advantage |
$2,115.62
|
| Rate for Payer: Cofinity Commercial |
$2,599.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.85
|
| Rate for Payer: Healthscope Commercial |
$2,720.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,417.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.73
|
| Rate for Payer: PHP Commercial |
$2,568.96
|
| Rate for Payer: Priority Health SBD |
$1,904.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,964.50
|
| Rate for Payer: UHC Core |
$1,574.62
|
| Rate for Payer: UHC Exchange |
$1,187.77
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
IP
|
$16.93
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.67 |
| Max. Negotiated Rate |
$15.24 |
| Rate for Payer: Aetna Commercial |
$14.39
|
| Rate for Payer: Aetna Commercial |
$19.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.99
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cofinity Advantage |
$11.85
|
| Rate for Payer: Cofinity Advantage |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$14.56
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.54
|
| Rate for Payer: Healthscope Commercial |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.30
|
| Rate for Payer: PHP Commercial |
$14.39
|
| Rate for Payer: PHP Commercial |
$19.60
|
| Rate for Payer: Priority Health SBD |
$10.67
|
| Rate for Payer: Priority Health SBD |
$14.53
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
IP
|
$18.54
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.68 |
| Max. Negotiated Rate |
$16.69 |
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$18.86
|
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Commercial |
$20.64
|
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.05
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$19.42
|
| Rate for Payer: Cofinity Advantage |
$10.70
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Advantage |
$13.23
|
| Rate for Payer: Cofinity Advantage |
$17.00
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$17.83
|
| Rate for Payer: Cofinity Advantage |
$12.98
|
| Rate for Payer: Cofinity Advantage |
$14.45
|
| Rate for Payer: Cofinity Advantage |
$15.53
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$20.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$19.97
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Healthscope Commercial |
$13.76
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$20.64
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$18.86
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: Priority Health SBD |
$11.91
|
| Rate for Payer: Priority Health SBD |
$13.98
|
| Rate for Payer: Priority Health SBD |
$13.00
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health SBD |
$16.05
|
| Rate for Payer: Priority Health SBD |
$9.63
|
| Rate for Payer: Priority Health SBD |
$11.04
|
| Rate for Payer: Priority Health SBD |
$11.68
|
| Rate for Payer: Priority Health SBD |
$15.30
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
OP
|
$18.54
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$16.69 |
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Commercial |
$18.86
|
| Rate for Payer: Aetna Commercial |
$20.64
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Aetna Medicare |
$9.45
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Aetna Medicare |
$8.77
|
| Rate for Payer: Aetna Medicare |
$9.27
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Aetna Medicare |
$11.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: BCBS Complete |
$8.88
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Complete |
$9.71
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$19.42
|
| Rate for Payer: Cash Price |
$19.42
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cofinity Advantage |
$17.83
|
| Rate for Payer: Cofinity Advantage |
$14.45
|
| Rate for Payer: Cofinity Advantage |
$12.98
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Advantage |
$15.53
|
| Rate for Payer: Cofinity Advantage |
$13.23
|
| Rate for Payer: Cofinity Advantage |
$10.70
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$17.00
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$13.15
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$20.88
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Healthscope Commercial |
$13.76
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$19.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: PHP Commercial |
$20.64
|
| Rate for Payer: PHP Commercial |
$18.86
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health SBD |
$15.30
|
| Rate for Payer: Priority Health SBD |
$13.00
|
| Rate for Payer: Priority Health SBD |
$9.63
|
| Rate for Payer: Priority Health SBD |
$11.04
|
| Rate for Payer: Priority Health SBD |
$11.68
|
| Rate for Payer: Priority Health SBD |
$13.98
|
| Rate for Payer: Priority Health SBD |
$16.05
|
| Rate for Payer: Priority Health SBD |
$11.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
OP
|
$23.06
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$20.75 |
| Rate for Payer: Aetna Commercial |
$19.60
|
| Rate for Payer: Aetna Commercial |
$14.39
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Aetna Medicare |
$8.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.99
|
| Rate for Payer: BCBS Complete |
$9.22
|
| Rate for Payer: BCBS Complete |
$6.77
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cofinity Advantage |
$11.85
|
| Rate for Payer: Cofinity Advantage |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Cofinity Commercial |
$14.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.54
|
| Rate for Payer: Healthscope Commercial |
$15.24
|
| Rate for Payer: Healthscope Commercial |
$20.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.30
|
| Rate for Payer: PHP Commercial |
$19.60
|
| Rate for Payer: PHP Commercial |
$14.39
|
| Rate for Payer: Priority Health SBD |
$10.67
|
| Rate for Payer: Priority Health SBD |
$14.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
|
|
VANCOMYCIN 100 MG/ML PF IV SOLN CUSTOM
|
Facility
|
IP
|
$17.53
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
150719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$15.78 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: Priority Health SBD |
$11.04
|
| Rate for Payer: Priority Health SBD |
$15.38
|
|
|
VANCOMYCIN 100 MG/ML PF IV SOLN CUSTOM
|
Facility
|
OP
|
$24.42
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
150719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna Medicare |
$8.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: Priority Health SBD |
$11.04
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$120.02
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
11627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$108.02 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Commercial |
$71.23
|
| Rate for Payer: Aetna Commercial |
$118.74
|
| Rate for Payer: Aetna Commercial |
$92.71
|
| Rate for Payer: Aetna Medicare |
$60.01
|
| Rate for Payer: Aetna Medicare |
$41.90
|
| Rate for Payer: Aetna Medicare |
$69.84
|
| Rate for Payer: Aetna Medicare |
$54.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| Rate for Payer: BCBS Complete |
$33.52
|
| Rate for Payer: BCBS Complete |
$48.01
|
| Rate for Payer: BCBS Complete |
$43.63
|
| Rate for Payer: BCBS Complete |
$55.88
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$111.75
|
| Rate for Payer: Cash Price |
$67.04
|
| Rate for Payer: Cash Price |
$111.75
|
| Rate for Payer: Cash Price |
$87.26
|
| Rate for Payer: Cash Price |
$87.26
|
| Rate for Payer: Cash Price |
$67.04
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Advantage |
$58.66
|
| Rate for Payer: Cofinity Advantage |
$76.35
|
| Rate for Payer: Cofinity Advantage |
$97.78
|
| Rate for Payer: Cofinity Advantage |
$84.01
|
| Rate for Payer: Cofinity Commercial |
$93.80
|
| Rate for Payer: Cofinity Commercial |
$72.07
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$120.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$125.72
|
| Rate for Payer: Healthscope Commercial |
$98.16
|
| Rate for Payer: Healthscope Commercial |
$75.42
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.85
|
| Rate for Payer: PHP Commercial |
$118.74
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: PHP Commercial |
$71.23
|
| Rate for Payer: PHP Commercial |
$92.71
|
| Rate for Payer: Priority Health SBD |
$68.71
|
| Rate for Payer: Priority Health SBD |
$88.00
|
| Rate for Payer: Priority Health SBD |
$52.79
|
| Rate for Payer: Priority Health SBD |
$75.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$139.69
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
11627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$125.72 |
| Rate for Payer: Aetna Commercial |
$118.74
|
| Rate for Payer: Aetna Commercial |
$71.23
|
| Rate for Payer: Aetna Commercial |
$92.71
|
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.90
|
| Rate for Payer: Cash Price |
$111.75
|
| Rate for Payer: Cash Price |
$67.04
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$87.26
|
| Rate for Payer: Cofinity Advantage |
$97.78
|
| Rate for Payer: Cofinity Advantage |
$76.35
|
| Rate for Payer: Cofinity Advantage |
$58.66
|
| Rate for Payer: Cofinity Advantage |
$84.01
|
| Rate for Payer: Cofinity Commercial |
$72.07
|
| Rate for Payer: Cofinity Commercial |
$120.13
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$93.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.75
|
| Rate for Payer: Healthscope Commercial |
$125.72
|
| Rate for Payer: Healthscope Commercial |
$75.42
|
| Rate for Payer: Healthscope Commercial |
$98.16
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.02
|
| Rate for Payer: PHP Commercial |
$118.74
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: PHP Commercial |
$92.71
|
| Rate for Payer: PHP Commercial |
$71.23
|
| Rate for Payer: Priority Health SBD |
$75.61
|
| Rate for Payer: Priority Health SBD |
$52.79
|
| Rate for Payer: Priority Health SBD |
$88.00
|
| Rate for Payer: Priority Health SBD |
$68.71
|
|
|
VANCOMYCIN 1 G POWDER (INTRA-OP)
|
Facility
|
IP
|
$24.42
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154997
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health SBD |
$11.04
|
|
|
VANCOMYCIN 1 G POWDER (INTRA-OP)
|
Facility
|
OP
|
$24.42
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154997
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$8.77
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.39
|
| Rate for Payer: BCBS Complete |
$7.01
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$14.02
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Healthscope Commercial |
$15.78
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.15
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health SBD |
$11.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 1 G WITH GELATIN POWDER 1 G IN 6ML NS IRRIGATION
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
NDC 00009000300
|
| Hospital Charge Code |
500529
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$53.36 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Advantage |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.52
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health SBD |
$53.36
|
|
|
VANCOMYCIN 1 G WITH GELATIN POWDER 1 G IN 6ML NS IRRIGATION
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
NDC 00009000300
|
| Hospital Charge Code |
500529
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.29 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: BCBS Complete |
$33.88
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Advantage |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.52
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.05
|
| Rate for Payer: UHC Core |
$44.13
|
| Rate for Payer: UHC Exchange |
$33.29
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
301723
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$26.10 |
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: Priority Health SBD |
$18.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
301723
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.27 |
| Max. Negotiated Rate |
$26.10 |
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: Priority Health SBD |
$18.27
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16.18
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$14.56 |
| Rate for Payer: Aetna Commercial |
$13.75
|
| Rate for Payer: Aetna Commercial |
$10.32
|
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Commercial |
$23.27
|
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: Aetna Commercial |
$15.89
|
| Rate for Payer: Aetna Medicare |
$13.69
|
| Rate for Payer: Aetna Medicare |
$13.68
|
| Rate for Payer: Aetna Medicare |
$6.07
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Aetna Medicare |
$9.35
|
| Rate for Payer: Aetna Medicare |
$16.43
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.83
|
| Rate for Payer: BCBS Complete |
$10.94
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Complete |
$6.47
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Complete |
$4.86
|
| Rate for Payer: BCBS Complete |
$13.14
|
| Rate for Payer: BCBS Complete |
$10.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$26.29
|
| Rate for Payer: Cash Price |
$26.29
|
| Rate for Payer: Cofinity Advantage |
$8.50
|
| Rate for Payer: Cofinity Advantage |
$20.28
|
| Rate for Payer: Cofinity Advantage |
$13.09
|
| Rate for Payer: Cofinity Advantage |
$23.00
|
| Rate for Payer: Cofinity Advantage |
$11.33
|
| Rate for Payer: Cofinity Advantage |
$19.14
|
| Rate for Payer: Cofinity Advantage |
$19.17
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Commercial |
$23.52
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Cofinity Commercial |
$28.26
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Cofinity Commercial |
$10.44
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Cofinity Commercial |
$23.55
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$29.57
|
| Rate for Payer: Healthscope Commercial |
$24.64
|
| Rate for Payer: Healthscope Commercial |
$24.61
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$14.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.51
|
| Rate for Payer: PHP Commercial |
$15.89
|
| Rate for Payer: PHP Commercial |
$23.27
|
| Rate for Payer: PHP Commercial |
$10.32
|
| Rate for Payer: PHP Commercial |
$13.75
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Commercial |
$23.25
|
| Rate for Payer: PHP Commercial |
$27.93
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: Priority Health SBD |
$10.19
|
| Rate for Payer: Priority Health SBD |
$20.70
|
| Rate for Payer: Priority Health SBD |
$18.25
|
| Rate for Payer: Priority Health SBD |
$11.78
|
| Rate for Payer: Priority Health SBD |
$17.25
|
| Rate for Payer: Priority Health SBD |
$18.27
|
| Rate for Payer: Priority Health SBD |
$7.65
|
| Rate for Payer: Priority Health SBD |
$17.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.97
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$26.07 |
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Commercial |
$10.32
|
| Rate for Payer: Aetna Commercial |
$15.89
|
| Rate for Payer: Aetna Commercial |
$23.27
|
| Rate for Payer: Aetna Commercial |
$13.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.80
|
| Rate for Payer: Cash Price |
$26.29
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Advantage |
$23.00
|
| Rate for Payer: Cofinity Advantage |
$19.17
|
| Rate for Payer: Cofinity Advantage |
$11.33
|
| Rate for Payer: Cofinity Advantage |
$20.28
|
| Rate for Payer: Cofinity Advantage |
$8.50
|
| Rate for Payer: Cofinity Advantage |
$19.14
|
| Rate for Payer: Cofinity Advantage |
$13.09
|
| Rate for Payer: Cofinity Commercial |
$23.52
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Cofinity Commercial |
$10.44
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Cofinity Commercial |
$23.55
|
| Rate for Payer: Cofinity Commercial |
$28.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$24.61
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$14.56
|
| Rate for Payer: Healthscope Commercial |
$24.64
|
| Rate for Payer: Healthscope Commercial |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$29.57
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.03
|
| Rate for Payer: PHP Commercial |
$13.75
|
| Rate for Payer: PHP Commercial |
$27.93
|
| Rate for Payer: PHP Commercial |
$23.25
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Commercial |
$10.32
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: PHP Commercial |
$15.89
|
| Rate for Payer: PHP Commercial |
$23.27
|
| Rate for Payer: Priority Health SBD |
$7.65
|
| Rate for Payer: Priority Health SBD |
$18.25
|
| Rate for Payer: Priority Health SBD |
$17.23
|
| Rate for Payer: Priority Health SBD |
$11.78
|
| Rate for Payer: Priority Health SBD |
$18.27
|
| Rate for Payer: Priority Health SBD |
$20.70
|
| Rate for Payer: Priority Health SBD |
$17.25
|
| Rate for Payer: Priority Health SBD |
$10.19
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$891.36
|
|
|
Service Code
|
NDC 65628020810
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$561.56 |
| Max. Negotiated Rate |
$802.22 |
| Rate for Payer: Aetna Commercial |
$757.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.38
|
| Rate for Payer: Cash Price |
$713.09
|
| Rate for Payer: Cofinity Advantage |
$623.95
|
| Rate for Payer: Cofinity Commercial |
$766.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.09
|
| Rate for Payer: Healthscope Commercial |
$802.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.52
|
| Rate for Payer: PHP Commercial |
$757.66
|
| Rate for Payer: Priority Health SBD |
$561.56
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$891.36
|
|
|
Service Code
|
NDC 65628020810
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$350.30 |
| Max. Negotiated Rate |
$802.22 |
| Rate for Payer: Aetna Commercial |
$757.66
|
| Rate for Payer: Aetna Medicare |
$445.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.38
|
| Rate for Payer: BCBS Complete |
$356.54
|
| Rate for Payer: Cash Price |
$713.09
|
| Rate for Payer: Cofinity Advantage |
$623.95
|
| Rate for Payer: Cofinity Commercial |
$766.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.09
|
| Rate for Payer: Healthscope Commercial |
$802.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$713.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.52
|
| Rate for Payer: PHP Commercial |
$757.66
|
| Rate for Payer: Priority Health SBD |
$561.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.38
|
| Rate for Payer: UHC Core |
$464.40
|
| Rate for Payer: UHC Exchange |
$350.30
|
|
