|
CLARITHROMYCIN 500 MG TABLET
|
Facility
|
OP
|
$278.73
|
|
|
Service Code
|
NDC 00781196260
|
| Hospital Charge Code |
9617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.49 |
| Max. Negotiated Rate |
$250.86 |
| Rate for Payer: Aetna Commercial |
$236.92
|
| Rate for Payer: Aetna Medicare |
$139.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.17
|
| Rate for Payer: BCBS Complete |
$111.49
|
| Rate for Payer: Cash Price |
$222.98
|
| Rate for Payer: Cofinity Commercial |
$195.11
|
| Rate for Payer: Cofinity Commercial |
$239.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.98
|
| Rate for Payer: Healthscope Commercial |
$250.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.92
|
| Rate for Payer: PHP Commercial |
$236.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.17
|
| Rate for Payer: Priority Health SBD |
$175.60
|
|
|
CLARITHROMYCIN 500 MG TABLET
|
Facility
|
OP
|
$284.84
|
|
|
Service Code
|
NDC 00904687204
|
| Hospital Charge Code |
9617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.94 |
| Max. Negotiated Rate |
$256.36 |
| Rate for Payer: Aetna Commercial |
$242.11
|
| Rate for Payer: Aetna Medicare |
$142.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.15
|
| Rate for Payer: BCBS Complete |
$113.94
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cofinity Commercial |
$199.39
|
| Rate for Payer: Cofinity Commercial |
$244.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$199.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.87
|
| Rate for Payer: Healthscope Commercial |
$256.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.11
|
| Rate for Payer: PHP Commercial |
$242.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.15
|
| Rate for Payer: Priority Health SBD |
$179.45
|
|
|
CLAVICULECTOMY; PARTIAL
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 23120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$628.57 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$1,271.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.57
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$5,811.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$23.40
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
1743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: Aetna Commercial |
$19.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.21
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cofinity Commercial |
$16.38
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.72
|
| Rate for Payer: Healthscope Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.89
|
| Rate for Payer: PHP Commercial |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.21
|
| Rate for Payer: Priority Health SBD |
$14.74
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$23.40
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
1743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: Aetna Commercial |
$19.89
|
| Rate for Payer: Aetna Medicare |
$11.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.21
|
| Rate for Payer: BCBS Complete |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cofinity Commercial |
$16.38
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.72
|
| Rate for Payer: Healthscope Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.89
|
| Rate for Payer: PHP Commercial |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.21
|
| Rate for Payer: Priority Health SBD |
$14.74
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
OP
|
$259.70
|
|
|
Service Code
|
NDC 00168027740
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$103.88 |
| Max. Negotiated Rate |
$233.73 |
| Rate for Payer: Aetna Commercial |
$220.74
|
| Rate for Payer: Aetna Medicare |
$129.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.80
|
| Rate for Payer: BCBS Complete |
$103.88
|
| Rate for Payer: Cash Price |
$207.76
|
| Rate for Payer: Cofinity Commercial |
$181.79
|
| Rate for Payer: Cofinity Commercial |
$223.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.76
|
| Rate for Payer: Healthscope Commercial |
$233.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.74
|
| Rate for Payer: PHP Commercial |
$220.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.80
|
| Rate for Payer: Priority Health SBD |
$163.61
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
IP
|
$259.70
|
|
|
Service Code
|
NDC 00168027740
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.61 |
| Max. Negotiated Rate |
$233.73 |
| Rate for Payer: Aetna Commercial |
$220.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.80
|
| Rate for Payer: Cash Price |
$207.76
|
| Rate for Payer: Cofinity Commercial |
$181.79
|
| Rate for Payer: Cofinity Commercial |
$223.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.76
|
| Rate for Payer: Healthscope Commercial |
$233.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.74
|
| Rate for Payer: PHP Commercial |
$220.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.80
|
| Rate for Payer: Priority Health SBD |
$163.61
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$20.19
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$7.93
|
| Rate for Payer: BCN Commercial |
$7.93
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$32.04
|
|
|
Service Code
|
HCPCS J7036
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$32.04
|
|
|
Service Code
|
HCPCS J7036
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$32.04
|
|
|
Service Code
|
NDC 00781328909
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$32.04
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$21.03
|
|
|
Service Code
|
NDC 09900000157
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.41 |
| Max. Negotiated Rate |
$18.93 |
| Rate for Payer: Aetna Commercial |
$17.88
|
| Rate for Payer: Aetna Medicare |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.67
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.88
|
| Rate for Payer: PHP Commercial |
$17.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.67
|
| Rate for Payer: Priority Health SBD |
$13.25
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$32.04
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.19 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$32.04
|
|
|
Service Code
|
NDC 00781328909
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$21.03
|
|
|
Service Code
|
NDC 09900000157
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$18.93 |
| Rate for Payer: Aetna Commercial |
$17.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.67
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.88
|
| Rate for Payer: PHP Commercial |
$17.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.67
|
| Rate for Payer: Priority Health SBD |
$13.25
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$385.40
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$242.80 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$385.40
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$192.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
|