|
ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18,918.62
|
|
|
Service Code
|
HCPCS J9177
|
| Hospital Charge Code |
192401
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11,918.73 |
| Max. Negotiated Rate |
$17,026.76 |
| Rate for Payer: Aetna Commercial |
$16,080.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,297.10
|
| Rate for Payer: Cash Price |
$15,134.90
|
| Rate for Payer: Cofinity Advantage |
$13,243.03
|
| Rate for Payer: Cofinity Commercial |
$16,270.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,134.90
|
| Rate for Payer: Healthscope Commercial |
$17,026.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,080.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,188.97
|
| Rate for Payer: PHP Commercial |
$16,080.83
|
| Rate for Payer: Priority Health SBD |
$11,918.73
|
|
|
ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18,918.62
|
|
|
Service Code
|
HCPCS J9177
|
| Hospital Charge Code |
192401
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$17,026.76 |
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Aetna Commercial |
$16,080.83
|
| Rate for Payer: Aetna Medicare |
$38.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,297.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.89
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.12
|
| Rate for Payer: BCN Commercial |
$92.12
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: Cash Price |
$15,134.90
|
| Rate for Payer: Cash Price |
$15,134.90
|
| Rate for Payer: Cofinity Advantage |
$13,243.03
|
| Rate for Payer: Cofinity Commercial |
$16,270.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,134.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Healthscope Commercial |
$17,026.76
|
| Rate for Payer: Mclaren Medicaid |
$19.20
|
| Rate for Payer: Mclaren Medicare |
$36.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.55
|
| Rate for Payer: Meridian Medicaid |
$38.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,080.83
|
| Rate for Payer: Nomi Health Commercial |
$110.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,188.97
|
| Rate for Payer: PACE Medicare |
$34.87
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PHP Commercial |
$16,080.83
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.88
|
| Rate for Payer: Priority Health SBD |
$11,918.73
|
| Rate for Payer: Priority Health Tiered Network |
$92.70
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.59
|
| Rate for Payer: UHC Core |
$60.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.71
|
| Rate for Payer: UHC Exchange |
$60.59
|
| Rate for Payer: UHC Medicaid |
$19.20
|
| Rate for Payer: UHCCP Medicaid |
$19.20
|
| Rate for Payer: VA VA |
$36.71
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$30.43
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$27.39 |
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$53.88
|
| Rate for Payer: Aetna Medicare |
$15.21
|
| Rate for Payer: Aetna Medicare |
$19.06
|
| Rate for Payer: Aetna Medicare |
$19.25
|
| Rate for Payer: Aetna Medicare |
$44.22
|
| Rate for Payer: Aetna Medicare |
$19.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.78
|
| Rate for Payer: BCBS Complete |
$15.25
|
| Rate for Payer: BCBS Complete |
$35.38
|
| Rate for Payer: BCBS Complete |
$15.40
|
| Rate for Payer: BCBS Complete |
$12.17
|
| Rate for Payer: BCBS Complete |
$43.10
|
| Rate for Payer: BCBS Complete |
$15.34
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.67
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cash Price |
$70.75
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$70.75
|
| Rate for Payer: Cash Price |
$30.67
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cofinity Advantage |
$75.43
|
| Rate for Payer: Cofinity Advantage |
$26.94
|
| Rate for Payer: Cofinity Advantage |
$26.84
|
| Rate for Payer: Cofinity Advantage |
$61.91
|
| Rate for Payer: Cofinity Advantage |
$26.68
|
| Rate for Payer: Cofinity Advantage |
$21.30
|
| Rate for Payer: Cofinity Commercial |
$32.78
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Cofinity Commercial |
$76.06
|
| Rate for Payer: Cofinity Commercial |
$32.97
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$79.60
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Healthscope Commercial |
$34.51
|
| Rate for Payer: Healthscope Commercial |
$34.31
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.33
|
| Rate for Payer: PHP Commercial |
$32.59
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: PHP Commercial |
$32.40
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Priority Health SBD |
$19.17
|
| Rate for Payer: Priority Health SBD |
$55.72
|
| Rate for Payer: Priority Health SBD |
$24.15
|
| Rate for Payer: Priority Health SBD |
$24.02
|
| Rate for Payer: Priority Health SBD |
$67.89
|
| 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 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
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$30.43
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$27.39 |
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.92
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$30.67
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cash Price |
$70.75
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cofinity Advantage |
$26.84
|
| Rate for Payer: Cofinity Advantage |
$75.43
|
| Rate for Payer: Cofinity Advantage |
$61.91
|
| Rate for Payer: Cofinity Advantage |
$21.30
|
| Rate for Payer: Cofinity Advantage |
$26.94
|
| Rate for Payer: Cofinity Advantage |
$26.68
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Cofinity Commercial |
$32.78
|
| Rate for Payer: Cofinity Commercial |
$76.06
|
| Rate for Payer: Cofinity Commercial |
$32.97
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.75
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$34.51
|
| Rate for Payer: Healthscope Commercial |
$34.31
|
| Rate for Payer: Healthscope Commercial |
$79.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.75
|
| Rate for Payer: PHP Commercial |
$32.59
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Commercial |
$32.40
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health SBD |
$24.02
|
| Rate for Payer: Priority Health SBD |
$24.15
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Priority Health SBD |
$67.89
|
| Rate for Payer: Priority Health SBD |
$19.17
|
| Rate for Payer: Priority Health SBD |
$55.72
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$35.29
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$31.76 |
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$31.77
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Medicare |
$64.68
|
| Rate for Payer: Aetna Medicare |
$17.64
|
| Rate for Payer: Aetna Medicare |
$18.69
|
| Rate for Payer: Aetna Medicare |
$22.80
|
| Rate for Payer: Aetna Medicare |
$37.25
|
| Rate for Payer: Aetna Medicare |
$22.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.30
|
| Rate for Payer: BCBS Complete |
$14.95
|
| Rate for Payer: BCBS Complete |
$29.80
|
| Rate for Payer: BCBS Complete |
$18.24
|
| Rate for Payer: BCBS Complete |
$14.12
|
| Rate for Payer: BCBS Complete |
$51.74
|
| Rate for Payer: BCBS Complete |
$18.14
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$36.29
|
| Rate for Payer: Cash Price |
$29.90
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$29.90
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$36.29
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cofinity Advantage |
$90.55
|
| Rate for Payer: Cofinity Advantage |
$31.93
|
| Rate for Payer: Cofinity Advantage |
$31.75
|
| Rate for Payer: Cofinity Advantage |
$52.15
|
| Rate for Payer: Cofinity Advantage |
$26.17
|
| Rate for Payer: Cofinity Advantage |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$111.25
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$39.01
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$40.82
|
| Rate for Payer: Healthscope Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.88
|
| Rate for Payer: PHP Commercial |
$38.56
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$31.77
|
| Rate for Payer: PHP Commercial |
$109.96
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: Priority Health SBD |
$22.23
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: Priority Health SBD |
$28.58
|
| Rate for Payer: Priority Health SBD |
$23.55
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| 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 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
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$35.29
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.23 |
| Max. Negotiated Rate |
$31.76 |
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Commercial |
$31.77
|
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.48
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$36.29
|
| Rate for Payer: Cash Price |
$29.90
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cofinity Advantage |
$31.75
|
| Rate for Payer: Cofinity Advantage |
$90.55
|
| Rate for Payer: Cofinity Advantage |
$52.15
|
| Rate for Payer: Cofinity Advantage |
$24.70
|
| Rate for Payer: Cofinity Advantage |
$31.93
|
| Rate for Payer: Cofinity Advantage |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$111.25
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$39.01
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$40.82
|
| Rate for Payer: Healthscope Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.02
|
| Rate for Payer: PHP Commercial |
$38.56
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$31.77
|
| Rate for Payer: PHP Commercial |
$109.96
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: Priority Health SBD |
$23.55
|
| Rate for Payer: Priority Health SBD |
$28.58
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| Rate for Payer: Priority Health SBD |
$22.23
|
| Rate for Payer: Priority Health SBD |
$46.94
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$93.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.67 |
| Max. Negotiated Rate |
$83.81 |
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cofinity Advantage |
$39.97
|
| Rate for Payer: Cofinity Advantage |
$34.07
|
| Rate for Payer: Cofinity Advantage |
$65.18
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Advantage |
$113.19
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.84
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: PHP Commercial |
$48.53
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: Priority Health SBD |
$35.97
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$83.57
|
| Rate for Payer: Priority Health SBD |
$58.67
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$93.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$83.81 |
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Commercial |
$48.53
|
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna Medicare |
$66.33
|
| Rate for Payer: Aetna Medicare |
$80.85
|
| Rate for Payer: Aetna Medicare |
$24.34
|
| Rate for Payer: Aetna Medicare |
$46.56
|
| Rate for Payer: Aetna Medicare |
$28.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: BCBS Complete |
$37.25
|
| Rate for Payer: BCBS Complete |
$64.68
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: BCBS Complete |
$53.06
|
| Rate for Payer: BCBS Complete |
$22.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cofinity Advantage |
$65.18
|
| Rate for Payer: Cofinity Advantage |
$39.97
|
| Rate for Payer: Cofinity Advantage |
$113.19
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Advantage |
$34.07
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.83
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$48.53
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: Priority Health SBD |
$35.97
|
| Rate for Payer: Priority Health SBD |
$58.67
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$83.57
|
| 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 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
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$821.23
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$739.11 |
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna Medicare |
$66.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$52.98
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$656.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| 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
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$132.44
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$119.20 |
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
OP
|
$821.23
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$739.11 |
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna Medicare |
$66.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$52.98
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$656.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| 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
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
IP
|
$132.44
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$119.20 |
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$25.63
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$23.07 |
| Rate for Payer: Aetna Commercial |
$21.79
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$15.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.66
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$20.50
|
| Rate for Payer: Cofinity Advantage |
$17.94
|
| Rate for Payer: Cofinity Advantage |
$22.60
|
| Rate for Payer: Cofinity Advantage |
$12.80
|
| Rate for Payer: Cofinity Advantage |
$11.81
|
| Rate for Payer: Cofinity Advantage |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$15.72
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$16.45
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.22
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$15.54
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$21.79
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: Priority Health SBD |
$16.15
|
| Rate for Payer: Priority Health SBD |
$11.52
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: Priority Health SBD |
$20.34
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$32.29
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$29.06 |
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$15.54
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$21.79
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Medicare |
$7.42
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Aetna Medicare |
$16.14
|
| Rate for Payer: Aetna Medicare |
$12.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: BCBS Complete |
$12.92
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$7.31
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS Complete |
$10.25
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$20.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$20.50
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cofinity Advantage |
$22.60
|
| Rate for Payer: Cofinity Advantage |
$17.94
|
| Rate for Payer: Cofinity Advantage |
$11.81
|
| Rate for Payer: Cofinity Advantage |
$10.39
|
| Rate for Payer: Cofinity Advantage |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$15.72
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$16.45
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.22
|
| Rate for Payer: PHP Commercial |
$15.54
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: PHP Commercial |
$21.79
|
| Rate for Payer: Priority Health SBD |
$11.52
|
| Rate for Payer: Priority Health SBD |
$16.15
|
| Rate for Payer: Priority Health SBD |
$20.34
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| 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 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
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$16.87
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$15.18 |
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Commercial |
$17.32
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Advantage |
$17.35
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Advantage |
$30.14
|
| Rate for Payer: Cofinity Advantage |
$11.81
|
| Rate for Payer: Cofinity Advantage |
$17.76
|
| Rate for Payer: Cofinity Advantage |
$14.27
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$17.53
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.59
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: PHP Commercial |
$17.32
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: Priority Health SBD |
$12.84
|
| Rate for Payer: Priority Health SBD |
$15.62
|
| Rate for Payer: Priority Health SBD |
$15.98
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$27.13
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$16.87
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$15.18 |
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$17.32
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Medicare |
$7.88
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Aetna Medicare |
$10.19
|
| Rate for Payer: Aetna Medicare |
$12.69
|
| Rate for Payer: Aetna Medicare |
$21.53
|
| Rate for Payer: Aetna Medicare |
$12.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.25
|
| Rate for Payer: BCBS Complete |
$8.15
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS Complete |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$6.31
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Advantage |
$17.76
|
| Rate for Payer: Cofinity Advantage |
$17.35
|
| Rate for Payer: Cofinity Advantage |
$30.14
|
| Rate for Payer: Cofinity Advantage |
$14.27
|
| Rate for Payer: Cofinity Advantage |
$11.81
|
| Rate for Payer: Cofinity Commercial |
$17.53
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$17.32
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: Priority Health SBD |
$15.98
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$27.13
|
| Rate for Payer: Priority Health SBD |
$15.62
|
| Rate for Payer: Priority Health SBD |
$12.84
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| 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 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
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$64.66
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$58.19 |
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Medicare |
$10.88
|
| Rate for Payer: Aetna Medicare |
$13.49
|
| Rate for Payer: Aetna Medicare |
$18.59
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.15
|
| Rate for Payer: BCBS Complete |
$25.86
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$14.87
|
| Rate for Payer: BCBS Complete |
$8.71
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cofinity Advantage |
$45.26
|
| Rate for Payer: Cofinity Advantage |
$26.07
|
| Rate for Payer: Cofinity Advantage |
$18.89
|
| Rate for Payer: Cofinity Advantage |
$15.24
|
| Rate for Payer: Cofinity Advantage |
$26.03
|
| Rate for Payer: Cofinity Commercial |
$31.97
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$58.19
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$19.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.94
|
| Rate for Payer: PHP Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Commercial |
$54.96
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: Priority Health SBD |
$23.42
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$40.74
|
| Rate for Payer: Priority Health SBD |
$17.00
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| 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 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
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$64.66
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.74 |
| Max. Negotiated Rate |
$58.19 |
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.03
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cofinity Advantage |
$26.07
|
| Rate for Payer: Cofinity Advantage |
$26.03
|
| Rate for Payer: Cofinity Advantage |
$45.26
|
| Rate for Payer: Cofinity Advantage |
$15.24
|
| Rate for Payer: Cofinity Advantage |
$18.89
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Cofinity Commercial |
$31.97
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.73
|
| Rate for Payer: Healthscope Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$58.19
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$19.59
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.49
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$54.96
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: PHP Commercial |
$31.60
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$23.42
|
| Rate for Payer: Priority Health SBD |
$17.00
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| Rate for Payer: Priority Health SBD |
$40.74
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$49.67
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$44.70 |
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: Aetna Commercial |
$60.13
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna Medicare |
$43.10
|
| Rate for Payer: Aetna Medicare |
$35.37
|
| Rate for Payer: Aetna Medicare |
$11.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.29
|
| Rate for Payer: BCBS Complete |
$34.48
|
| Rate for Payer: BCBS Complete |
$19.87
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Complete |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: BCN Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cofinity Advantage |
$60.35
|
| Rate for Payer: Cofinity Advantage |
$15.62
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Advantage |
$34.77
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.66
|
| Rate for Payer: PHP Commercial |
$60.13
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: Priority Health SBD |
$14.06
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health SBD |
$54.31
|
| Rate for Payer: Priority Health SBD |
$31.29
|
| 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 Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$70.74
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.57 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.13
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.50
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Advantage |
$15.62
|
| Rate for Payer: Cofinity Advantage |
$60.35
|
| Rate for Payer: Cofinity Advantage |
$34.77
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.59
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.25
|
| Rate for Payer: PHP Commercial |
$60.13
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: Priority Health SBD |
$31.29
|
| Rate for Payer: Priority Health SBD |
$54.31
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health SBD |
$14.06
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$428.58
|
|
|
Service Code
|
NDC 60687018821
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$168.43 |
| Max. Negotiated Rate |
$385.72 |
| Rate for Payer: Aetna Commercial |
$364.29
|
| Rate for Payer: Aetna Medicare |
$214.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.58
|
| Rate for Payer: BCBS Complete |
$171.43
|
| Rate for Payer: Cash Price |
$342.86
|
| Rate for Payer: Cofinity Advantage |
$300.01
|
| Rate for Payer: Cofinity Commercial |
$368.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.86
|
| Rate for Payer: Healthscope Commercial |
$385.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.44
|
| Rate for Payer: PHP Commercial |
$364.29
|
| Rate for Payer: Priority Health SBD |
$270.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.58
|
| Rate for Payer: UHC Core |
$223.29
|
| Rate for Payer: UHC Exchange |
$168.43
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$14.29
|
|
|
Service Code
|
NDC 60687018811
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$12.86 |
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.29
|
| Rate for Payer: Cash Price |
$11.43
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.43
|
| Rate for Payer: Healthscope Commercial |
$12.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: Priority Health SBD |
$9.00
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$14.29
|
|
|
Service Code
|
NDC 60687018811
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$12.86 |
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.29
|
| Rate for Payer: BCBS Complete |
$5.72
|
| Rate for Payer: Cash Price |
$11.43
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.43
|
| Rate for Payer: Healthscope Commercial |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.29
|
| Rate for Payer: UHC Core |
$7.45
|
| Rate for Payer: UHC Exchange |
$5.62
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$428.58
|
|
|
Service Code
|
NDC 60687018821
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$270.01 |
| Max. Negotiated Rate |
$385.72 |
| Rate for Payer: Aetna Commercial |
$364.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.58
|
| Rate for Payer: Cash Price |
$342.86
|
| Rate for Payer: Cofinity Advantage |
$300.01
|
| Rate for Payer: Cofinity Commercial |
$368.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.86
|
| Rate for Payer: Healthscope Commercial |
$385.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.44
|
| Rate for Payer: PHP Commercial |
$364.29
|
| Rate for Payer: Priority Health SBD |
$270.01
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$256.32
|
|
|
Service Code
|
NDC 65862065401
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.48 |
| Max. Negotiated Rate |
$230.69 |
| Rate for Payer: Aetna Commercial |
$217.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.61
|
| Rate for Payer: Cash Price |
$205.06
|
| Rate for Payer: Cofinity Advantage |
$179.42
|
| Rate for Payer: Cofinity Commercial |
$220.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.06
|
| Rate for Payer: Healthscope Commercial |
$230.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.24
|
| Rate for Payer: PHP Commercial |
$217.87
|
| Rate for Payer: Priority Health SBD |
$161.48
|
|
