|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$957.60
|
|
|
Service Code
|
NDC 65628020110
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$603.29 |
| Max. Negotiated Rate |
$861.84 |
| Rate for Payer: Aetna Commercial |
$813.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.44
|
| Rate for Payer: Cash Price |
$766.08
|
| Rate for Payer: Cofinity Advantage |
$670.32
|
| Rate for Payer: Cofinity Commercial |
$823.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.08
|
| Rate for Payer: Healthscope Commercial |
$861.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$813.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.20
|
| Rate for Payer: PHP Commercial |
$813.96
|
| Rate for Payer: Priority Health SBD |
$603.29
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$891.36
|
|
|
Service Code
|
NDC 65628001610
|
| 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
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$1,216.80
|
|
|
Service Code
|
NDC 52536010810
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$766.58 |
| Max. Negotiated Rate |
$1,095.12 |
| Rate for Payer: Aetna Commercial |
$1,034.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.92
|
| Rate for Payer: Cash Price |
$973.44
|
| Rate for Payer: Cofinity Advantage |
$851.76
|
| Rate for Payer: Cofinity Commercial |
$1,046.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$973.44
|
| Rate for Payer: Healthscope Commercial |
$1,095.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.60
|
| Rate for Payer: PHP Commercial |
$1,034.28
|
| Rate for Payer: Priority Health SBD |
$766.58
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$1,216.80
|
|
|
Service Code
|
NDC 52536010810
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$478.20 |
| Max. Negotiated Rate |
$1,095.12 |
| Rate for Payer: Aetna Commercial |
$1,034.28
|
| Rate for Payer: Aetna Medicare |
$608.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.92
|
| Rate for Payer: BCBS Complete |
$486.72
|
| Rate for Payer: Cash Price |
$973.44
|
| Rate for Payer: Cofinity Advantage |
$851.76
|
| Rate for Payer: Cofinity Commercial |
$1,046.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$973.44
|
| Rate for Payer: Healthscope Commercial |
$1,095.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$973.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.60
|
| Rate for Payer: PHP Commercial |
$1,034.28
|
| Rate for Payer: Priority Health SBD |
$766.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$790.92
|
| Rate for Payer: UHC Core |
$633.95
|
| Rate for Payer: UHC Exchange |
$478.20
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$957.60
|
|
|
Service Code
|
NDC 65628020110
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$376.34 |
| Max. Negotiated Rate |
$861.84 |
| Rate for Payer: Aetna Commercial |
$813.96
|
| Rate for Payer: Aetna Medicare |
$478.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.44
|
| Rate for Payer: BCBS Complete |
$383.04
|
| Rate for Payer: Cash Price |
$766.08
|
| Rate for Payer: Cofinity Advantage |
$670.32
|
| Rate for Payer: Cofinity Commercial |
$823.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.08
|
| Rate for Payer: Healthscope Commercial |
$861.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$766.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$813.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.20
|
| Rate for Payer: PHP Commercial |
$813.96
|
| Rate for Payer: Priority Health SBD |
$603.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.44
|
| Rate for Payer: UHC Core |
$498.91
|
| Rate for Payer: UHC Exchange |
$376.34
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$891.36
|
|
|
Service Code
|
NDC 65628001610
|
| 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 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$57.10
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.97 |
| Max. Negotiated Rate |
$51.39 |
| Rate for Payer: Aetna Commercial |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cofinity Advantage |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.83
|
| Rate for Payer: PHP Commercial |
$48.53
|
| Rate for Payer: Priority Health SBD |
$35.97
|
|
|
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$57.10
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$51.39 |
| Rate for Payer: Aetna Commercial |
$48.53
|
| Rate for Payer: Aetna Medicare |
$28.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: BCBS Complete |
$22.84
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cofinity Advantage |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.83
|
| Rate for Payer: PHP Commercial |
$48.53
|
| Rate for Payer: Priority Health SBD |
$35.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
|
|
VANCOMYCIN 5 MG/ML IV SPECIAL DILUTION
|
Facility
|
IP
|
$10.38
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154952
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$9.34 |
| Rate for Payer: Aetna Commercial |
$8.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.75
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cofinity Advantage |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.30
|
| Rate for Payer: Healthscope Commercial |
$9.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.79
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: Priority Health SBD |
$6.54
|
|
|
VANCOMYCIN 5 MG/ML IV SPECIAL DILUTION
|
Facility
|
OP
|
$10.38
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154952
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$9.34 |
| Rate for Payer: Aetna Commercial |
$8.82
|
| Rate for Payer: Aetna Medicare |
$5.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.75
|
| Rate for Payer: BCBS Complete |
$4.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cofinity Advantage |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.30
|
| Rate for Payer: Healthscope Commercial |
$9.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.79
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: Priority Health SBD |
$6.54
|
| 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 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.62
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$19.46 |
| Rate for Payer: Aetna Commercial |
$18.38
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.05
|
| Rate for Payer: BCBS Complete |
$8.65
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$17.30
|
| Rate for Payer: Cash Price |
$17.30
|
| Rate for Payer: Cofinity Advantage |
$15.13
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: Priority Health SBD |
$13.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.62
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.62 |
| Max. Negotiated Rate |
$19.46 |
| Rate for Payer: Aetna Commercial |
$18.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.05
|
| Rate for Payer: Cash Price |
$17.30
|
| Rate for Payer: Cofinity Advantage |
$15.13
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Healthscope Commercial |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: Priority Health SBD |
$13.62
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$30.92
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$27.83 |
| Rate for Payer: Aetna Commercial |
$26.28
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Commercial |
$33.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Cash Price |
$31.42
|
| Rate for Payer: Cash Price |
$24.74
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$21.64
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Advantage |
$27.50
|
| Rate for Payer: Cofinity Commercial |
$33.78
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Commercial |
$26.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.42
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$27.83
|
| Rate for Payer: Healthscope Commercial |
$35.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Commercial |
$33.39
|
| Rate for Payer: PHP Commercial |
$26.28
|
| Rate for Payer: Priority Health SBD |
$24.75
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Priority Health SBD |
$19.48
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Commercial |
$26.28
|
| Rate for Payer: Aetna Commercial |
$33.39
|
| Rate for Payer: Aetna Medicare |
$10.75
|
| Rate for Payer: Aetna Medicare |
$15.46
|
| Rate for Payer: Aetna Medicare |
$19.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.53
|
| Rate for Payer: BCBS Complete |
$15.71
|
| Rate for Payer: BCBS Complete |
$8.60
|
| Rate for Payer: BCBS Complete |
$12.37
|
| 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: Cash Price |
$31.42
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$24.74
|
| Rate for Payer: Cash Price |
$31.42
|
| Rate for Payer: Cash Price |
$24.74
|
| Rate for Payer: Cofinity Advantage |
$21.64
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Advantage |
$27.50
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Commercial |
$26.59
|
| Rate for Payer: Cofinity Commercial |
$33.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$35.35
|
| Rate for Payer: Healthscope Commercial |
$27.83
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.46
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Commercial |
$26.28
|
| Rate for Payer: PHP Commercial |
$33.39
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Priority Health SBD |
$24.75
|
| Rate for Payer: Priority Health SBD |
$19.48
|
| 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 Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
|
|
VANCOMYCIN 750 MG IVPB (IV-PREMIX)
|
Facility
|
OP
|
$75.77
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
302077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$68.19 |
| Rate for Payer: Aetna Commercial |
$64.40
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.25
|
| Rate for Payer: BCBS Complete |
$30.31
|
| Rate for Payer: BCBS Trust/PPO |
$0.07
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: Cash Price |
$60.62
|
| Rate for Payer: Cash Price |
$60.62
|
| Rate for Payer: Cofinity Advantage |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$65.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.62
|
| Rate for Payer: Healthscope Commercial |
$68.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.83
|
| Rate for Payer: PHP Commercial |
$64.40
|
| Rate for Payer: Priority Health SBD |
$47.74
|
| 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 750 MG IVPB (IV-PREMIX)
|
Facility
|
IP
|
$75.77
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
302077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$68.19 |
| Rate for Payer: Aetna Commercial |
$64.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.25
|
| Rate for Payer: Cash Price |
$60.62
|
| Rate for Payer: Cofinity Advantage |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$65.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.62
|
| Rate for Payer: Healthscope Commercial |
$68.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.83
|
| Rate for Payer: PHP Commercial |
$64.40
|
| Rate for Payer: Priority Health SBD |
$47.74
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$1,343.88
|
|
|
Service Code
|
NDC 60687064821
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$528.14 |
| Max. Negotiated Rate |
$1,209.49 |
| Rate for Payer: Aetna Commercial |
$1,142.30
|
| Rate for Payer: Aetna Medicare |
$671.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.52
|
| Rate for Payer: BCBS Complete |
$537.55
|
| Rate for Payer: Cash Price |
$1,075.10
|
| Rate for Payer: Cofinity Advantage |
$940.72
|
| Rate for Payer: Cofinity Commercial |
$1,155.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.10
|
| Rate for Payer: Healthscope Commercial |
$1,209.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,075.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,142.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.91
|
| Rate for Payer: PHP Commercial |
$1,142.30
|
| Rate for Payer: Priority Health SBD |
$846.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.52
|
| Rate for Payer: UHC Core |
$700.16
|
| Rate for Payer: UHC Exchange |
$528.14
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$44.80
|
|
|
Service Code
|
NDC 60687064811
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.22 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Advantage |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.60
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: Priority Health SBD |
$28.22
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$1,343.88
|
|
|
Service Code
|
NDC 60687064821
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$846.64 |
| Max. Negotiated Rate |
$1,209.49 |
| Rate for Payer: Aetna Commercial |
$1,142.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.52
|
| Rate for Payer: Cash Price |
$1,075.10
|
| Rate for Payer: Cofinity Advantage |
$940.72
|
| Rate for Payer: Cofinity Commercial |
$1,155.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.10
|
| Rate for Payer: Healthscope Commercial |
$1,209.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,142.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.91
|
| Rate for Payer: PHP Commercial |
$1,142.30
|
| Rate for Payer: Priority Health SBD |
$846.64
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$44.80
|
|
|
Service Code
|
NDC 60687064811
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna Medicare |
$22.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: BCBS Complete |
$17.92
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Advantage |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.60
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: Priority Health SBD |
$28.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.12
|
| Rate for Payer: UHC Core |
$23.34
|
| Rate for Payer: UHC Exchange |
$17.61
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
OP
|
$55.93
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Aetna Medicare |
$27.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
IP
|
$55.93
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$27.06
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.06 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$39.23
|
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$37.65
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$32.30
|
| Rate for Payer: Cofinity Advantage |
$85.16
|
| Rate for Payer: Cofinity Advantage |
$108.40
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$39.86
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$41.53
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$39.23
|
| Rate for Payer: PHP Commercial |
$37.65
|
| Rate for Payer: Priority Health SBD |
$29.07
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: Priority Health SBD |
$76.64
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: Priority Health SBD |
$35.24
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$44.29
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$39.86 |
| Rate for Payer: Aetna Commercial |
$37.65
|
| Rate for Payer: Aetna Commercial |
$40.10
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$39.23
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Medicare |
$77.43
|
| Rate for Payer: Aetna Medicare |
$23.59
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Aetna Medicare |
$27.96
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Aetna Medicare |
$60.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.00
|
| Rate for Payer: BCBS Complete |
$17.72
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Complete |
$18.46
|
| Rate for Payer: BCBS Complete |
$48.66
|
| Rate for Payer: BCBS Complete |
$61.94
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: BCN Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Advantage |
$108.40
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$85.16
|
| Rate for Payer: Cofinity Advantage |
$33.03
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Advantage |
$32.30
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Cofinity Commercial |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.92
|
| Rate for Payer: Healthscope Commercial |
$42.46
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$41.53
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$39.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.38
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$37.65
|
| Rate for Payer: PHP Commercial |
$39.23
|
| Rate for Payer: PHP Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: Priority Health SBD |
$29.72
|
| Rate for Payer: Priority Health SBD |
$76.64
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$29.07
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$330.84
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$208.43 |
| Max. Negotiated Rate |
$297.76 |
| Rate for Payer: Aetna Commercial |
$281.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.05
|
| Rate for Payer: Cash Price |
$264.67
|
| Rate for Payer: Cofinity Advantage |
$231.59
|
| Rate for Payer: Cofinity Commercial |
$284.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.67
|
| Rate for Payer: Healthscope Commercial |
$297.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.13
|
| Rate for Payer: PHP Commercial |
$281.21
|
| Rate for Payer: Priority Health SBD |
$208.43
|
|
