|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$196.70
|
|
|
Service Code
|
NDC 69097094705
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.92 |
| Max. Negotiated Rate |
$177.03 |
| Rate for Payer: Aetna Commercial |
$167.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.86
|
| Rate for Payer: Cash Price |
$157.36
|
| Rate for Payer: Cofinity Advantage |
$137.69
|
| Rate for Payer: Cofinity Commercial |
$169.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.36
|
| Rate for Payer: Healthscope Commercial |
$177.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.53
|
| Rate for Payer: PHP Commercial |
$167.19
|
| Rate for Payer: Priority Health SBD |
$123.92
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$304.56
|
|
|
Service Code
|
NDC 00378395377
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.69 |
| Max. Negotiated Rate |
$274.10 |
| Rate for Payer: Aetna Commercial |
$258.88
|
| Rate for Payer: Aetna Medicare |
$152.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.96
|
| Rate for Payer: BCBS Complete |
$121.82
|
| Rate for Payer: Cash Price |
$243.65
|
| Rate for Payer: Cofinity Advantage |
$213.19
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.65
|
| Rate for Payer: Healthscope Commercial |
$274.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.42
|
| Rate for Payer: PHP Commercial |
$258.88
|
| Rate for Payer: Priority Health SBD |
$191.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.96
|
| Rate for Payer: UHC Core |
$158.68
|
| Rate for Payer: UHC Exchange |
$119.69
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$133.67
|
|
|
Service Code
|
NDC 00904629304
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.21 |
| Max. Negotiated Rate |
$120.30 |
| Rate for Payer: Aetna Commercial |
$113.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.89
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cofinity Advantage |
$93.57
|
| Rate for Payer: Cofinity Commercial |
$114.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.94
|
| Rate for Payer: Healthscope Commercial |
$120.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.25
|
| Rate for Payer: PHP Commercial |
$113.62
|
| Rate for Payer: Priority Health SBD |
$84.21
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$999.94
|
|
|
Service Code
|
NDC 31722062921
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$392.98 |
| Max. Negotiated Rate |
$899.95 |
| Rate for Payer: Aetna Commercial |
$849.95
|
| Rate for Payer: Aetna Medicare |
$499.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.96
|
| Rate for Payer: BCBS Complete |
$399.98
|
| Rate for Payer: Cash Price |
$799.95
|
| Rate for Payer: Cofinity Advantage |
$699.96
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.95
|
| Rate for Payer: Healthscope Commercial |
$899.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.96
|
| Rate for Payer: PHP Commercial |
$849.95
|
| Rate for Payer: Priority Health SBD |
$629.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.96
|
| Rate for Payer: UHC Core |
$520.97
|
| Rate for Payer: UHC Exchange |
$392.98
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$999.94
|
|
|
Service Code
|
NDC 31722062921
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$629.96 |
| Max. Negotiated Rate |
$899.95 |
| Rate for Payer: Aetna Commercial |
$849.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.96
|
| Rate for Payer: Cash Price |
$799.95
|
| Rate for Payer: Cofinity Advantage |
$699.96
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.95
|
| Rate for Payer: Healthscope Commercial |
$899.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.96
|
| Rate for Payer: PHP Commercial |
$849.95
|
| Rate for Payer: Priority Health SBD |
$629.96
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$29.95
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna Commercial |
$36.66
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna Medicare |
$18.11
|
| Rate for Payer: Aetna Medicare |
$21.57
|
| Rate for Payer: Aetna Medicare |
$36.31
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: BCBS Complete |
$14.49
|
| Rate for Payer: BCBS Complete |
$29.05
|
| Rate for Payer: BCBS Complete |
$17.25
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS Complete |
$11.88
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Advantage |
$30.19
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Cofinity Commercial |
$37.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$38.82
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: PHP Commercial |
$36.66
|
| Rate for Payer: Priority Health SBD |
$27.17
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: Priority Health SBD |
$27.08
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$42.99
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$38.69 |
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Commercial |
$36.66
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cofinity Advantage |
$30.19
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$37.09
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$38.82
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$36.66
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: Priority Health SBD |
$27.08
|
| Rate for Payer: Priority Health SBD |
$27.17
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$18.72
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$42.99
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$38.69 |
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$27.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$29.95
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$27.08
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$18.46
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$16.61 |
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Commercial |
$104.70
|
| Rate for Payer: Aetna Medicare |
$61.59
|
| Rate for Payer: Aetna Medicare |
$9.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.07
|
| Rate for Payer: BCBS Complete |
$49.27
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cofinity Advantage |
$12.92
|
| Rate for Payer: Cofinity Advantage |
$86.23
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$105.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.77
|
| Rate for Payer: Healthscope Commercial |
$110.86
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.39
|
| Rate for Payer: PHP Commercial |
$15.69
|
| Rate for Payer: PHP Commercial |
$104.70
|
| Rate for Payer: Priority Health SBD |
$11.63
|
| Rate for Payer: Priority Health SBD |
$77.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$18.46
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$16.61 |
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Commercial |
$104.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.00
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cofinity Advantage |
$12.92
|
| Rate for Payer: Cofinity Advantage |
$86.23
|
| Rate for Payer: Cofinity Commercial |
$105.93
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.77
|
| Rate for Payer: Healthscope Commercial |
$110.86
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.39
|
| Rate for Payer: PHP Commercial |
$104.70
|
| Rate for Payer: PHP Commercial |
$15.69
|
| Rate for Payer: Priority Health SBD |
$77.60
|
| Rate for Payer: Priority Health SBD |
$11.63
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
OP
|
$18.50
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301845
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Medicare |
$9.23
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.00
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Advantage |
$12.92
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.69
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
| Rate for Payer: Priority Health SBD |
$11.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
IP
|
$18.50
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301845
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
|
|
ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.50
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195980
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
|
|
ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.50
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195980
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
NDC 70069058101
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.76 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
NDC 70069058101
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$24.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: BCBS Complete |
$19.53
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.74
|
| Rate for Payer: UHC Core |
$25.44
|
| Rate for Payer: UHC Exchange |
$19.19
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
OP
|
$291.33
|
|
|
Service Code
|
NDC 17478021515
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.49 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Aetna Commercial |
$247.63
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.36
|
| Rate for Payer: BCBS Complete |
$116.53
|
| Rate for Payer: Cash Price |
$233.06
|
| Rate for Payer: Cofinity Advantage |
$203.93
|
| Rate for Payer: Cofinity Commercial |
$250.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.06
|
| Rate for Payer: Healthscope Commercial |
$262.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.50
|
| Rate for Payer: PHP Commercial |
$247.63
|
| Rate for Payer: Priority Health SBD |
$183.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.36
|
| Rate for Payer: UHC Core |
$151.78
|
| Rate for Payer: UHC Exchange |
$114.49
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
OP
|
$68.04
|
|
|
Service Code
|
NDC 70756065125
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$61.24 |
| Rate for Payer: Aetna Commercial |
$57.83
|
| Rate for Payer: Aetna Medicare |
$34.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.23
|
| Rate for Payer: BCBS Complete |
$27.22
|
| Rate for Payer: Cash Price |
$54.43
|
| Rate for Payer: Cofinity Advantage |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$58.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$61.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.03
|
| Rate for Payer: PHP Commercial |
$57.83
|
| Rate for Payer: Priority Health SBD |
$42.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.23
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$26.74
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
IP
|
$291.33
|
|
|
Service Code
|
NDC 17478021515
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$183.54 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Aetna Commercial |
$247.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.36
|
| Rate for Payer: Cash Price |
$233.06
|
| Rate for Payer: Cofinity Advantage |
$203.93
|
| Rate for Payer: Cofinity Commercial |
$250.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.06
|
| Rate for Payer: Healthscope Commercial |
$262.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.50
|
| Rate for Payer: PHP Commercial |
$247.63
|
| Rate for Payer: Priority Health SBD |
$183.54
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
IP
|
$68.04
|
|
|
Service Code
|
NDC 70756065125
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.87 |
| Max. Negotiated Rate |
$61.24 |
| Rate for Payer: Aetna Commercial |
$57.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.23
|
| Rate for Payer: Cash Price |
$54.43
|
| Rate for Payer: Cofinity Advantage |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$58.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$61.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.03
|
| Rate for Payer: PHP Commercial |
$57.83
|
| Rate for Payer: Priority Health SBD |
$42.87
|
|
|
ATROPINE 1 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
OP
|
$30.35
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301597
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$27.32 |
| Rate for Payer: Aetna Commercial |
$25.80
|
| Rate for Payer: Aetna Commercial |
$25.75
|
| Rate for Payer: Aetna Medicare |
$15.14
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.69
|
| Rate for Payer: BCBS Complete |
$12.14
|
| Rate for Payer: BCBS Complete |
$12.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: BCN Commercial |
$0.25
|
| Rate for Payer: Cash Price |
$24.23
|
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Cash Price |
$24.23
|
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Cofinity Advantage |
$21.25
|
| Rate for Payer: Cofinity Advantage |
$21.20
|
| Rate for Payer: Cofinity Commercial |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.28
|
| Rate for Payer: Healthscope Commercial |
$27.26
|
| Rate for Payer: Healthscope Commercial |
$27.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.76
|
| Rate for Payer: PHP Commercial |
$25.80
|
| Rate for Payer: PHP Commercial |
$25.75
|
| Rate for Payer: Priority Health SBD |
$19.12
|
| Rate for Payer: Priority Health SBD |
$19.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
ATROPINE 1 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
IP
|
$30.29
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301597
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$27.26 |
| Rate for Payer: Aetna Commercial |
$25.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.69
|
| Rate for Payer: Cash Price |
$24.23
|
| Rate for Payer: Cofinity Advantage |
$21.20
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.23
|
| Rate for Payer: Healthscope Commercial |
$27.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.72
|
| Rate for Payer: PHP Commercial |
$25.75
|
| Rate for Payer: Priority Health SBD |
$19.08
|
|
|
ATROPINE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$30.35
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$27.32 |
| Rate for Payer: Aetna Commercial |
$25.80
|
| Rate for Payer: Aetna Commercial |
$24.98
|
| Rate for Payer: Aetna Commercial |
$40.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.10
|
| Rate for Payer: Cash Price |
$37.93
|
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Cash Price |
$23.51
|
| Rate for Payer: Cofinity Advantage |
$21.25
|
| Rate for Payer: Cofinity Advantage |
$20.57
|
| Rate for Payer: Cofinity Advantage |
$33.19
|
| Rate for Payer: Cofinity Commercial |
$40.77
|
| Rate for Payer: Cofinity Commercial |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$26.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.93
|
| Rate for Payer: Healthscope Commercial |
$26.45
|
| Rate for Payer: Healthscope Commercial |
$27.32
|
| Rate for Payer: Healthscope Commercial |
$42.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.76
|
| Rate for Payer: PHP Commercial |
$24.98
|
| Rate for Payer: PHP Commercial |
$40.30
|
| Rate for Payer: PHP Commercial |
$25.80
|
| Rate for Payer: Priority Health SBD |
$29.87
|
| Rate for Payer: Priority Health SBD |
$18.52
|
| Rate for Payer: Priority Health SBD |
$19.12
|
|
|
ATROPINE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.39
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$26.45 |
| Rate for Payer: Aetna Commercial |
$24.98
|
| Rate for Payer: Aetna Commercial |
$25.80
|
| Rate for Payer: Aetna Commercial |
$40.30
|
| Rate for Payer: Aetna Medicare |
$14.70
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna Medicare |
$23.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.82
|
| Rate for Payer: BCBS Complete |
$18.96
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS Complete |
$12.14
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$37.93
|
| Rate for Payer: Cash Price |
$23.51
|
| Rate for Payer: Cash Price |
$23.51
|
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Cash Price |
$37.93
|
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Cofinity Advantage |
$21.25
|
| Rate for Payer: Cofinity Advantage |
$20.57
|
| Rate for Payer: Cofinity Advantage |
$33.19
|
| Rate for Payer: Cofinity Commercial |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$40.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$42.67
|
| Rate for Payer: Healthscope Commercial |
$27.32
|
| Rate for Payer: Healthscope Commercial |
$26.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.56
|
| Rate for Payer: PHP Commercial |
$24.98
|
| Rate for Payer: PHP Commercial |
$25.80
|
| Rate for Payer: PHP Commercial |
$40.30
|
| Rate for Payer: Priority Health SBD |
$18.52
|
| Rate for Payer: Priority Health SBD |
$29.87
|
| Rate for Payer: Priority Health SBD |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
|
