|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
OP
|
$24.84
|
|
|
Service Code
|
NDC 00641623801
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$22.36 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health SBD |
$15.65
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 65219025701
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$26.07 |
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.83
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$20.28
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health SBD |
$18.25
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
OP
|
$34.71
|
|
|
Service Code
|
NDC 70121163705
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.88 |
| Max. Negotiated Rate |
$31.24 |
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: Aetna Medicare |
$17.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.56
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: Cash Price |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Cofinity Commercial |
$29.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.77
|
| Rate for Payer: Healthscope Commercial |
$31.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.56
|
| Rate for Payer: Priority Health SBD |
$21.87
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
OP
|
$24.84
|
|
|
Service Code
|
NDC 00641623825
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$22.36 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health SBD |
$15.65
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
OP
|
$18.07
|
|
|
Service Code
|
NDC 55150037325
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna Medicare |
$9.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.75
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health SBD |
$11.38
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$24.84
|
|
|
Service Code
|
NDC 00641623825
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$22.36 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health SBD |
$15.65
|
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$31.11
|
|
|
Service Code
|
NDC 70121163701
|
| Hospital Charge Code |
300142
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$28.00 |
| Rate for Payer: Aetna Commercial |
$26.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.22
|
| Rate for Payer: Cash Price |
$24.89
|
| Rate for Payer: Cofinity Commercial |
$21.78
|
| Rate for Payer: Cofinity Commercial |
$26.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.89
|
| Rate for Payer: Healthscope Commercial |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.44
|
| Rate for Payer: PHP Commercial |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.22
|
| Rate for Payer: Priority Health SBD |
$19.60
|
|
|
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.84
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
179024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.65 |
| Max. Negotiated Rate |
$22.36 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Commercial |
$15.78
|
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$14.85
|
| Rate for Payer: Cofinity Commercial |
$20.28
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Cofinity Commercial |
$12.99
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.85
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$16.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.78
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.06
|
| Rate for Payer: Priority Health SBD |
$15.65
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: Priority Health SBD |
$11.69
|
| Rate for Payer: Priority Health SBD |
$18.25
|
|
|
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.84
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
179024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$22.36 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Commercial |
$15.78
|
| Rate for Payer: Aetna Commercial |
$24.62
|
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Aetna Medicare |
$9.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.83
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$14.85
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$20.28
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Commercial |
$12.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.85
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$16.70
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.78
|
| Rate for Payer: PHP Commercial |
$24.62
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.83
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: Priority Health SBD |
$15.65
|
| Rate for Payer: Priority Health SBD |
$11.69
|
| Rate for Payer: Priority Health SBD |
$18.25
|
|
|
EPIDIDYMECTOMY; UNILATERAL
|
Facility
|
OP
|
$10,620.87
|
|
|
Service Code
|
CPT 54860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$444.07 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$914.83
|
| Rate for Payer: BCN Commercial |
$914.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.07
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,902.51
|
| Rate for Payer: VA VA |
$3,379.23
|
|
|
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$39.52
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
2848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$35.57 |
| Rate for Payer: Aetna Commercial |
$33.59
|
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: Aetna Commercial |
$36.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.98
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Cofinity Commercial |
$30.62
|
| Rate for Payer: Cofinity Commercial |
$27.66
|
| Rate for Payer: Cofinity Commercial |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$30.13
|
| Rate for Payer: Cofinity Commercial |
$37.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.43
|
| Rate for Payer: Healthscope Commercial |
$32.04
|
| Rate for Payer: Healthscope Commercial |
$35.57
|
| Rate for Payer: Healthscope Commercial |
$38.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.58
|
| Rate for Payer: PHP Commercial |
$33.59
|
| Rate for Payer: PHP Commercial |
$36.58
|
| Rate for Payer: PHP Commercial |
$30.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.14
|
| Rate for Payer: Priority Health SBD |
$27.12
|
| Rate for Payer: Priority Health SBD |
$24.90
|
| Rate for Payer: Priority Health SBD |
$22.43
|
|
|
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$43.04
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
2848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$38.74 |
| Rate for Payer: Aetna Commercial |
$36.58
|
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: Aetna Commercial |
$33.59
|
| Rate for Payer: Aetna Medicare |
$17.80
|
| Rate for Payer: Aetna Medicare |
$19.76
|
| Rate for Payer: Aetna Medicare |
$21.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.98
|
| Rate for Payer: BCBS Complete |
$15.81
|
| Rate for Payer: BCBS Complete |
$14.24
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Cofinity Commercial |
$27.66
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Cofinity Commercial |
$30.62
|
| Rate for Payer: Cofinity Commercial |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$30.13
|
| Rate for Payer: Cofinity Commercial |
$37.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.43
|
| Rate for Payer: Healthscope Commercial |
$35.57
|
| Rate for Payer: Healthscope Commercial |
$32.04
|
| Rate for Payer: Healthscope Commercial |
$38.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.58
|
| Rate for Payer: PHP Commercial |
$33.59
|
| Rate for Payer: PHP Commercial |
$36.58
|
| Rate for Payer: PHP Commercial |
$30.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.14
|
| Rate for Payer: Priority Health SBD |
$22.43
|
| Rate for Payer: Priority Health SBD |
$27.12
|
| Rate for Payer: Priority Health SBD |
$24.90
|
|
|
EPINEPHRINE 0.1MG/ML-LIDOCAINE 1% (1:3) TOPICAL ENT SYRINGE
|
Facility
|
IP
|
$20.30
|
|
|
Service Code
|
NDC 09900000974
|
| Hospital Charge Code |
180619
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$18.27 |
| Rate for Payer: Aetna Commercial |
$17.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.20
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$14.21
|
| Rate for Payer: Cofinity Commercial |
$17.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.24
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.26
|
| Rate for Payer: PHP Commercial |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.20
|
| Rate for Payer: Priority Health SBD |
$12.79
|
|
|
EPINEPHRINE 0.1MG/ML-LIDOCAINE 1% (1:3) TOPICAL ENT SYRINGE
|
Facility
|
OP
|
$20.30
|
|
|
Service Code
|
NDC 09900000974
|
| Hospital Charge Code |
180619
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.12 |
| Max. Negotiated Rate |
$18.27 |
| Rate for Payer: Aetna Commercial |
$17.26
|
| Rate for Payer: Aetna Medicare |
$10.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.20
|
| Rate for Payer: BCBS Complete |
$8.12
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$14.21
|
| Rate for Payer: Cofinity Commercial |
$17.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.24
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.26
|
| Rate for Payer: PHP Commercial |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.20
|
| Rate for Payer: Priority Health SBD |
$12.79
|
|
|
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
|
Facility
|
OP
|
$940.93
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
100491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$846.84 |
| Rate for Payer: Aetna Commercial |
$799.79
|
| Rate for Payer: Aetna Commercial |
$342.63
|
| Rate for Payer: Aetna Commercial |
$685.24
|
| Rate for Payer: Aetna Commercial |
$399.90
|
| Rate for Payer: Aetna Medicare |
$403.08
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna Medicare |
$470.46
|
| Rate for Payer: Aetna Medicare |
$235.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.81
|
| Rate for Payer: BCBS Complete |
$322.47
|
| Rate for Payer: BCBS Complete |
$376.37
|
| Rate for Payer: BCBS Complete |
$188.19
|
| Rate for Payer: BCBS Complete |
$161.24
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: Cash Price |
$376.38
|
| Rate for Payer: Cash Price |
$322.47
|
| Rate for Payer: Cash Price |
$644.94
|
| Rate for Payer: Cash Price |
$376.38
|
| Rate for Payer: Cash Price |
$644.94
|
| Rate for Payer: Cash Price |
$752.74
|
| Rate for Payer: Cash Price |
$752.74
|
| Rate for Payer: Cash Price |
$322.47
|
| Rate for Payer: Cofinity Commercial |
$329.33
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Cofinity Commercial |
$346.66
|
| Rate for Payer: Cofinity Commercial |
$404.60
|
| Rate for Payer: Cofinity Commercial |
$564.32
|
| Rate for Payer: Cofinity Commercial |
$693.31
|
| Rate for Payer: Cofinity Commercial |
$658.65
|
| Rate for Payer: Cofinity Commercial |
$809.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$658.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$564.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.38
|
| Rate for Payer: Healthscope Commercial |
$423.42
|
| Rate for Payer: Healthscope Commercial |
$846.84
|
| Rate for Payer: Healthscope Commercial |
$725.55
|
| Rate for Payer: Healthscope Commercial |
$362.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.79
|
| Rate for Payer: PHP Commercial |
$799.79
|
| Rate for Payer: PHP Commercial |
$399.90
|
| Rate for Payer: PHP Commercial |
$685.24
|
| Rate for Payer: PHP Commercial |
$342.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.81
|
| Rate for Payer: Priority Health SBD |
$592.79
|
| Rate for Payer: Priority Health SBD |
$296.40
|
| Rate for Payer: Priority Health SBD |
$253.95
|
| Rate for Payer: Priority Health SBD |
$507.89
|
|
|
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
|
Facility
|
IP
|
$806.17
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
100491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$507.89 |
| Max. Negotiated Rate |
$725.55 |
| Rate for Payer: Aetna Commercial |
$685.24
|
| Rate for Payer: Aetna Commercial |
$399.90
|
| Rate for Payer: Aetna Commercial |
$799.79
|
| Rate for Payer: Aetna Commercial |
$342.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.60
|
| Rate for Payer: Cash Price |
$644.94
|
| Rate for Payer: Cash Price |
$376.38
|
| Rate for Payer: Cash Price |
$322.47
|
| Rate for Payer: Cash Price |
$752.74
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Cofinity Commercial |
$809.20
|
| Rate for Payer: Cofinity Commercial |
$658.65
|
| Rate for Payer: Cofinity Commercial |
$329.33
|
| Rate for Payer: Cofinity Commercial |
$404.60
|
| Rate for Payer: Cofinity Commercial |
$693.31
|
| Rate for Payer: Cofinity Commercial |
$564.32
|
| Rate for Payer: Cofinity Commercial |
$346.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$564.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$658.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.74
|
| Rate for Payer: Healthscope Commercial |
$423.42
|
| Rate for Payer: Healthscope Commercial |
$362.78
|
| Rate for Payer: Healthscope Commercial |
$846.84
|
| Rate for Payer: Healthscope Commercial |
$725.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.63
|
| Rate for Payer: PHP Commercial |
$342.63
|
| Rate for Payer: PHP Commercial |
$685.24
|
| Rate for Payer: PHP Commercial |
$399.90
|
| Rate for Payer: PHP Commercial |
$799.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.60
|
| Rate for Payer: Priority Health SBD |
$253.95
|
| Rate for Payer: Priority Health SBD |
$507.89
|
| Rate for Payer: Priority Health SBD |
$296.40
|
| Rate for Payer: Priority Health SBD |
$592.79
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$57.94
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$49.25
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: BCBS Complete |
$23.18
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cofinity Commercial |
$40.56
|
| Rate for Payer: Cofinity Commercial |
$49.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
| Rate for Payer: Healthscope Commercial |
$52.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.25
|
| Rate for Payer: PHP Commercial |
$49.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.66
|
| Rate for Payer: Priority Health SBD |
$36.50
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$57.94
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.50 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$49.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cofinity Commercial |
$40.56
|
| Rate for Payer: Cofinity Commercial |
$49.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
| Rate for Payer: Healthscope Commercial |
$52.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.25
|
| Rate for Payer: PHP Commercial |
$49.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.66
|
| Rate for Payer: Priority Health SBD |
$36.50
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$408.54
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$257.38 |
| Max. Negotiated Rate |
$367.69 |
| Rate for Payer: Aetna Commercial |
$347.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.55
|
| Rate for Payer: Cash Price |
$326.83
|
| Rate for Payer: Cofinity Commercial |
$285.98
|
| Rate for Payer: Cofinity Commercial |
$351.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.83
|
| Rate for Payer: Healthscope Commercial |
$367.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.26
|
| Rate for Payer: PHP Commercial |
$347.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.55
|
| Rate for Payer: Priority Health SBD |
$257.38
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$408.54
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$367.69 |
| Rate for Payer: Aetna Commercial |
$347.26
|
| Rate for Payer: Aetna Medicare |
$204.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.55
|
| Rate for Payer: BCBS Complete |
$163.42
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: Cash Price |
$326.83
|
| Rate for Payer: Cash Price |
$326.83
|
| Rate for Payer: Cofinity Commercial |
$285.98
|
| Rate for Payer: Cofinity Commercial |
$351.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.83
|
| Rate for Payer: Healthscope Commercial |
$367.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.26
|
| Rate for Payer: PHP Commercial |
$347.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.55
|
| Rate for Payer: Priority Health SBD |
$257.38
|
|
|
EPINEPHRINE 1 MG/ML NASAL SOLUTION
|
Facility
|
OP
|
$812.49
|
|
|
Service Code
|
NDC 42023010301
|
| Hospital Charge Code |
19604
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$325.00 |
| Max. Negotiated Rate |
$731.24 |
| Rate for Payer: Aetna Commercial |
$690.62
|
| Rate for Payer: Aetna Medicare |
$406.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.12
|
| Rate for Payer: BCBS Complete |
$325.00
|
| Rate for Payer: Cash Price |
$649.99
|
| Rate for Payer: Cofinity Commercial |
$568.74
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$568.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.99
|
| Rate for Payer: Healthscope Commercial |
$731.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.62
|
| Rate for Payer: PHP Commercial |
$690.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.12
|
| Rate for Payer: Priority Health SBD |
$511.87
|
|
|
EPINEPHRINE 1 MG/ML NASAL SOLUTION
|
Facility
|
IP
|
$812.49
|
|
|
Service Code
|
NDC 42023010301
|
| Hospital Charge Code |
19604
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$511.87 |
| Max. Negotiated Rate |
$731.24 |
| Rate for Payer: Aetna Commercial |
$690.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.12
|
| Rate for Payer: Cash Price |
$649.99
|
| Rate for Payer: Cofinity Commercial |
$568.74
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$568.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.99
|
| Rate for Payer: Healthscope Commercial |
$731.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.62
|
| Rate for Payer: PHP Commercial |
$690.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.12
|
| Rate for Payer: Priority Health SBD |
$511.87
|
|
|
EPINEPHRINE 2 MG IN OXYMETAZOLINE SOLN 32 ML
|
Facility
|
OP
|
$37.60
|
|
|
Service Code
|
NDC 09900000792
|
| Hospital Charge Code |
180291
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$33.84 |
| Rate for Payer: Aetna Commercial |
$31.96
|
| Rate for Payer: Aetna Medicare |
$18.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.44
|
| Rate for Payer: BCBS Complete |
$15.04
|
| Rate for Payer: Cash Price |
$30.08
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$32.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.08
|
| Rate for Payer: Healthscope Commercial |
$33.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.96
|
| Rate for Payer: PHP Commercial |
$31.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.44
|
| Rate for Payer: Priority Health SBD |
$23.69
|
|
|
EPINEPHRINE 2 MG IN OXYMETAZOLINE SOLN 32 ML
|
Facility
|
IP
|
$37.60
|
|
|
Service Code
|
NDC 09900000792
|
| Hospital Charge Code |
180291
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.69 |
| Max. Negotiated Rate |
$33.84 |
| Rate for Payer: Aetna Commercial |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.44
|
| Rate for Payer: Cash Price |
$30.08
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$32.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.08
|
| Rate for Payer: Healthscope Commercial |
$33.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.96
|
| Rate for Payer: PHP Commercial |
$31.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.44
|
| Rate for Payer: Priority Health SBD |
$23.69
|
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
OP
|
$62.31
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
181607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$56.08 |
| Rate for Payer: Aetna Commercial |
$52.96
|
| Rate for Payer: Aetna Medicare |
$31.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.50
|
| Rate for Payer: BCBS Complete |
$24.92
|
| Rate for Payer: BCBS Trust/PPO |
$2.33
|
| Rate for Payer: BCN Commercial |
$2.33
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$43.62
|
| Rate for Payer: Cofinity Commercial |
$53.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
| Rate for Payer: Healthscope Commercial |
$56.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.96
|
| Rate for Payer: PHP Commercial |
$52.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.50
|
| Rate for Payer: Priority Health SBD |
$39.26
|
|
