|
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION
|
Facility
|
OP
|
$24.56
|
|
|
Service Code
|
HCPCS J7608
|
| Hospital Charge Code |
123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Commercial |
$46.72
|
| Rate for Payer: Aetna Medicare |
$27.48
|
| Rate for Payer: Aetna Medicare |
$12.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.72
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS Complete |
$21.98
|
| Rate for Payer: Cash Price |
$19.65
|
| Rate for Payer: Cash Price |
$43.97
|
| Rate for Payer: Cash Price |
$43.97
|
| Rate for Payer: Cash Price |
$19.65
|
| Rate for Payer: Cofinity Commercial |
$17.19
|
| Rate for Payer: Cofinity Commercial |
$21.12
|
| Rate for Payer: Cofinity Commercial |
$47.27
|
| Rate for Payer: Cofinity Commercial |
$38.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Commercial |
$49.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.72
|
| Rate for Payer: PHP Commercial |
$20.88
|
| Rate for Payer: PHP Commercial |
$46.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.15
|
| Rate for Payer: Priority Health Narrow Network |
$6.52
|
| Rate for Payer: Priority Health Narrow Network |
$6.52
|
| Rate for Payer: Priority Health SBD |
$34.62
|
| Rate for Payer: Priority Health SBD |
$15.47
|
|
|
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION
|
Facility
|
IP
|
$24.56
|
|
|
Service Code
|
HCPCS J7608
|
| Hospital Charge Code |
123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Commercial |
$46.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.72
|
| Rate for Payer: Cash Price |
$19.65
|
| Rate for Payer: Cash Price |
$43.97
|
| Rate for Payer: Cofinity Commercial |
$17.19
|
| Rate for Payer: Cofinity Commercial |
$38.47
|
| Rate for Payer: Cofinity Commercial |
$47.27
|
| Rate for Payer: Cofinity Commercial |
$21.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.97
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Commercial |
$49.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.72
|
| Rate for Payer: PHP Commercial |
$20.88
|
| Rate for Payer: PHP Commercial |
$46.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.96
|
| Rate for Payer: Priority Health SBD |
$34.62
|
| Rate for Payer: Priority Health SBD |
$15.47
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
IP
|
$78.12
|
|
|
Service Code
|
NDC 00574052108
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.22 |
| Max. Negotiated Rate |
$70.31 |
| Rate for Payer: Aetna Commercial |
$66.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.78
|
| Rate for Payer: Cash Price |
$62.50
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Cofinity Commercial |
$67.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.50
|
| Rate for Payer: Healthscope Commercial |
$70.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.40
|
| Rate for Payer: PHP Commercial |
$66.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.78
|
| Rate for Payer: Priority Health SBD |
$49.22
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
IP
|
$85.68
|
|
|
Service Code
|
NDC 66689020208
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.98 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$72.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.69
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$59.98
|
| Rate for Payer: Cofinity Commercial |
$73.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.54
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.83
|
| Rate for Payer: PHP Commercial |
$72.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.69
|
| Rate for Payer: Priority Health SBD |
$53.98
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
IP
|
$97.44
|
|
|
Service Code
|
NDC 66689020108
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$61.39 |
| Max. Negotiated Rate |
$87.70 |
| Rate for Payer: Aetna Commercial |
$82.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.34
|
| Rate for Payer: Cash Price |
$77.95
|
| Rate for Payer: Cofinity Commercial |
$68.21
|
| Rate for Payer: Cofinity Commercial |
$83.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.95
|
| Rate for Payer: Healthscope Commercial |
$87.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.82
|
| Rate for Payer: PHP Commercial |
$82.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.34
|
| Rate for Payer: Priority Health SBD |
$61.39
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
OP
|
$85.68
|
|
|
Service Code
|
NDC 66689020208
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.27 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$72.83
|
| Rate for Payer: Aetna Medicare |
$42.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.69
|
| Rate for Payer: BCBS Complete |
$34.27
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$59.98
|
| Rate for Payer: Cofinity Commercial |
$73.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.54
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.83
|
| Rate for Payer: PHP Commercial |
$72.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.69
|
| Rate for Payer: Priority Health SBD |
$53.98
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
OP
|
$97.44
|
|
|
Service Code
|
NDC 66689020108
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$87.70 |
| Rate for Payer: Aetna Commercial |
$82.82
|
| Rate for Payer: Aetna Medicare |
$48.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.34
|
| Rate for Payer: BCBS Complete |
$38.98
|
| Rate for Payer: Cash Price |
$77.95
|
| Rate for Payer: Cofinity Commercial |
$68.21
|
| Rate for Payer: Cofinity Commercial |
$83.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.95
|
| Rate for Payer: Healthscope Commercial |
$87.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.82
|
| Rate for Payer: PHP Commercial |
$82.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.34
|
| Rate for Payer: Priority Health SBD |
$61.39
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
|
OP
|
$78.12
|
|
|
Service Code
|
NDC 00574052108
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.25 |
| Max. Negotiated Rate |
$70.31 |
| Rate for Payer: Aetna Commercial |
$66.40
|
| Rate for Payer: Aetna Medicare |
$39.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.78
|
| Rate for Payer: BCBS Complete |
$31.25
|
| Rate for Payer: Cash Price |
$62.50
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Cofinity Commercial |
$67.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.50
|
| Rate for Payer: Healthscope Commercial |
$70.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.40
|
| Rate for Payer: PHP Commercial |
$66.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.78
|
| Rate for Payer: Priority Health SBD |
$49.22
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$1,367.21
|
|
|
Service Code
|
NDC 50383081016
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$546.88 |
| Max. Negotiated Rate |
$1,230.49 |
| Rate for Payer: Aetna Commercial |
$1,162.13
|
| Rate for Payer: Aetna Medicare |
$683.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.69
|
| Rate for Payer: BCBS Complete |
$546.88
|
| Rate for Payer: Cash Price |
$1,093.77
|
| Rate for Payer: Cofinity Commercial |
$1,175.80
|
| Rate for Payer: Cofinity Commercial |
$957.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$957.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.77
|
| Rate for Payer: Healthscope Commercial |
$1,230.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.13
|
| Rate for Payer: PHP Commercial |
$1,162.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.69
|
| Rate for Payer: Priority Health SBD |
$861.34
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$1,911.87
|
|
|
Service Code
|
NDC 70954018810
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$764.75 |
| Max. Negotiated Rate |
$1,720.68 |
| Rate for Payer: Aetna Commercial |
$1,625.09
|
| Rate for Payer: Aetna Medicare |
$955.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.72
|
| Rate for Payer: BCBS Complete |
$764.75
|
| Rate for Payer: Cash Price |
$1,529.50
|
| Rate for Payer: Cofinity Commercial |
$1,338.31
|
| Rate for Payer: Cofinity Commercial |
$1,644.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,338.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,529.50
|
| Rate for Payer: Healthscope Commercial |
$1,720.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.09
|
| Rate for Payer: PHP Commercial |
$1,625.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.72
|
| Rate for Payer: Priority Health SBD |
$1,204.48
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,911.87
|
|
|
Service Code
|
NDC 70954018810
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,204.48 |
| Max. Negotiated Rate |
$1,720.68 |
| Rate for Payer: Aetna Commercial |
$1,625.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.72
|
| Rate for Payer: Cash Price |
$1,529.50
|
| Rate for Payer: Cofinity Commercial |
$1,338.31
|
| Rate for Payer: Cofinity Commercial |
$1,644.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,338.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,529.50
|
| Rate for Payer: Healthscope Commercial |
$1,720.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.09
|
| Rate for Payer: PHP Commercial |
$1,625.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.72
|
| Rate for Payer: Priority Health SBD |
$1,204.48
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$1,589.28
|
|
|
Service Code
|
NDC 00472008216
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$635.71 |
| Max. Negotiated Rate |
$1,430.35 |
| Rate for Payer: Aetna Commercial |
$1,350.89
|
| Rate for Payer: Aetna Medicare |
$794.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.03
|
| Rate for Payer: BCBS Complete |
$635.71
|
| Rate for Payer: Cash Price |
$1,271.42
|
| Rate for Payer: Cofinity Commercial |
$1,112.50
|
| Rate for Payer: Cofinity Commercial |
$1,366.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.42
|
| Rate for Payer: Healthscope Commercial |
$1,430.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.89
|
| Rate for Payer: PHP Commercial |
$1,350.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.03
|
| Rate for Payer: Priority Health SBD |
$1,001.25
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,589.28
|
|
|
Service Code
|
NDC 00472008216
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,001.25 |
| Max. Negotiated Rate |
$1,430.35 |
| Rate for Payer: Aetna Commercial |
$1,350.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.03
|
| Rate for Payer: Cash Price |
$1,271.42
|
| Rate for Payer: Cofinity Commercial |
$1,112.50
|
| Rate for Payer: Cofinity Commercial |
$1,366.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.42
|
| Rate for Payer: Healthscope Commercial |
$1,430.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.89
|
| Rate for Payer: PHP Commercial |
$1,350.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.03
|
| Rate for Payer: Priority Health SBD |
$1,001.25
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,367.21
|
|
|
Service Code
|
NDC 50383081016
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$861.34 |
| Max. Negotiated Rate |
$1,230.49 |
| Rate for Payer: Aetna Commercial |
$1,162.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.69
|
| Rate for Payer: Cash Price |
$1,093.77
|
| Rate for Payer: Cofinity Commercial |
$1,175.80
|
| Rate for Payer: Cofinity Commercial |
$957.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$957.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.77
|
| Rate for Payer: Healthscope Commercial |
$1,230.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.13
|
| Rate for Payer: PHP Commercial |
$1,162.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.69
|
| Rate for Payer: Priority Health SBD |
$861.34
|
|
|
ACYCLOVIR 400 MG TABLET
|
Facility
|
OP
|
$203.30
|
|
|
Service Code
|
NDC 00904579061
|
| Hospital Charge Code |
8971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.32 |
| Max. Negotiated Rate |
$182.97 |
| Rate for Payer: Aetna Commercial |
$172.80
|
| Rate for Payer: Aetna Medicare |
$101.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.14
|
| Rate for Payer: BCBS Complete |
$81.32
|
| Rate for Payer: Cash Price |
$162.64
|
| Rate for Payer: Cofinity Commercial |
$142.31
|
| Rate for Payer: Cofinity Commercial |
$174.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.64
|
| Rate for Payer: Healthscope Commercial |
$182.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.80
|
| Rate for Payer: PHP Commercial |
$172.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.14
|
| Rate for Payer: Priority Health SBD |
$128.08
|
|
|
ACYCLOVIR 400 MG TABLET
|
Facility
|
IP
|
$203.30
|
|
|
Service Code
|
NDC 00904579061
|
| Hospital Charge Code |
8971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.08 |
| Max. Negotiated Rate |
$182.97 |
| Rate for Payer: Aetna Commercial |
$172.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.14
|
| Rate for Payer: Cash Price |
$162.64
|
| Rate for Payer: Cofinity Commercial |
$142.31
|
| Rate for Payer: Cofinity Commercial |
$174.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.64
|
| Rate for Payer: Healthscope Commercial |
$182.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.80
|
| Rate for Payer: PHP Commercial |
$172.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.14
|
| Rate for Payer: Priority Health SBD |
$128.08
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.65
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$20.38 |
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Commercial |
$16.42
|
| Rate for Payer: Aetna Medicare |
$10.03
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna Medicare |
$11.32
|
| Rate for Payer: Aetna Medicare |
$9.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.56
|
| Rate for Payer: BCBS Complete |
$8.02
|
| Rate for Payer: BCBS Complete |
$9.06
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$13.52
|
| Rate for Payer: Cofinity Commercial |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$15.86
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.46
|
| Rate for Payer: Healthscope Commercial |
$17.39
|
| Rate for Payer: Healthscope Commercial |
$20.38
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: PHP Commercial |
$16.42
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.56
|
| Rate for Payer: Priority Health SBD |
$14.27
|
| Rate for Payer: Priority Health SBD |
$12.17
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Priority Health SBD |
$12.64
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.06
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Commercial |
$16.42
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.72
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$15.86
|
| Rate for Payer: Cofinity Commercial |
$13.52
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Healthscope Commercial |
$17.39
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$20.38
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$16.42
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.72
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Priority Health SBD |
$12.64
|
| Rate for Payer: Priority Health SBD |
$12.17
|
| Rate for Payer: Priority Health SBD |
$14.27
|
|
|
ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT
|
Facility
|
IP
|
$17,548.83
|
|
|
Service Code
|
HCPCS J0139
|
| Hospital Charge Code |
34652
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11,055.76 |
| Max. Negotiated Rate |
$15,793.95 |
| Rate for Payer: Aetna Commercial |
$14,916.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,406.74
|
| Rate for Payer: Cash Price |
$14,039.06
|
| Rate for Payer: Cofinity Commercial |
$12,284.18
|
| Rate for Payer: Cofinity Commercial |
$15,091.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,284.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,039.06
|
| Rate for Payer: Healthscope Commercial |
$15,793.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,916.51
|
| Rate for Payer: PHP Commercial |
$14,916.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,406.74
|
| Rate for Payer: Priority Health SBD |
$11,055.76
|
|
|
ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT
|
Facility
|
OP
|
$17,548.83
|
|
|
Service Code
|
HCPCS J0139
|
| Hospital Charge Code |
34652
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$49.17 |
| Max. Negotiated Rate |
$15,793.95 |
| Rate for Payer: Aetna Commercial |
$14,916.51
|
| Rate for Payer: Aetna Medicare |
$95.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,406.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.66
|
| Rate for Payer: BCBS Complete |
$51.63
|
| Rate for Payer: BCBS MAPPO |
$91.73
|
| Rate for Payer: BCN Medicare Advantage |
$91.73
|
| Rate for Payer: Cash Price |
$14,039.06
|
| Rate for Payer: Cash Price |
$14,039.06
|
| Rate for Payer: Cofinity Commercial |
$12,284.18
|
| Rate for Payer: Cofinity Commercial |
$15,091.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,284.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,039.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.73
|
| Rate for Payer: Healthscope Commercial |
$15,793.95
|
| Rate for Payer: Mclaren Medicaid |
$49.17
|
| Rate for Payer: Mclaren Medicare |
$91.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.32
|
| Rate for Payer: Meridian Medicaid |
$51.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,916.51
|
| Rate for Payer: Nomi Health Commercial |
$275.19
|
| Rate for Payer: PACE Medicare |
$87.14
|
| Rate for Payer: PACE SWMI |
$91.73
|
| Rate for Payer: PHP Commercial |
$14,916.51
|
| Rate for Payer: PHP Medicare Advantage |
$91.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,406.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.00
|
| Rate for Payer: Priority Health Medicare |
$91.73
|
| Rate for Payer: Priority Health Narrow Network |
$211.20
|
| Rate for Payer: Priority Health SBD |
$11,055.76
|
| Rate for Payer: Railroad Medicare Medicare |
$91.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.73
|
| Rate for Payer: UHC Medicare Advantage |
$91.73
|
| Rate for Payer: UHCCP Medicaid |
$51.64
|
| Rate for Payer: VA VA |
$91.73
|
|
|
ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 42831
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$244.11 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,595.78
|
| Rate for Payer: BCN Commercial |
$1,595.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.11
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 42830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.40
|
| Rate for Payer: BCN Commercial |
$1,305.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.14
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
ADENOIDECTOMY, SECONDARY; YOUNGER THAN AGE 12
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 42835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$209.78 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$980.72
|
| Rate for Payer: BCN Commercial |
$980.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.78
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.26
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
8975
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$22.73 |
| Rate for Payer: Aetna Commercial |
$21.47
|
| Rate for Payer: Aetna Commercial |
$14.67
|
| Rate for Payer: Aetna Commercial |
$21.03
|
| Rate for Payer: Aetna Medicare |
$8.63
|
| Rate for Payer: Aetna Medicare |
$12.37
|
| Rate for Payer: Aetna Medicare |
$12.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.42
|
| Rate for Payer: BCBS Complete |
$9.90
|
| Rate for Payer: BCBS Complete |
$6.90
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: BCN Commercial |
$1.11
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cash Price |
$13.81
|
| Rate for Payer: Cash Price |
$20.21
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cash Price |
$13.81
|
| Rate for Payer: Cash Price |
$20.21
|
| Rate for Payer: Cofinity Commercial |
$17.32
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Cofinity Commercial |
$14.84
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$21.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.21
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$15.53
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$21.03
|
| Rate for Payer: PHP Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$14.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.22
|
| Rate for Payer: Priority Health SBD |
$10.87
|
| Rate for Payer: Priority Health SBD |
$15.91
|
| Rate for Payer: Priority Health SBD |
$15.59
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.26
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
8975
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$15.53 |
| Rate for Payer: Aetna Commercial |
$14.67
|
| Rate for Payer: Aetna Commercial |
$21.03
|
| Rate for Payer: Aetna Commercial |
$21.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.42
|
| Rate for Payer: Cash Price |
$13.81
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cash Price |
$20.21
|
| Rate for Payer: Cofinity Commercial |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Cofinity Commercial |
$14.84
|
| Rate for Payer: Cofinity Commercial |
$21.72
|
| Rate for Payer: Cofinity Commercial |
$17.32
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.21
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$14.67
|
| Rate for Payer: PHP Commercial |
$21.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.08
|
| Rate for Payer: Priority Health SBD |
$15.91
|
| Rate for Payer: Priority Health SBD |
$10.87
|
| Rate for Payer: Priority Health SBD |
$15.59
|
|
