|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$12.71
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$10.80
|
| Rate for Payer: Aetna Commercial |
$14.83
|
| Rate for Payer: Aetna Commercial |
$17.49
|
| Rate for Payer: Aetna Commercial |
$10.67
|
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Commercial |
$9.85
|
| Rate for Payer: Aetna Commercial |
$9.49
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Aetna Medicare |
$8.72
|
| Rate for Payer: Aetna Medicare |
$8.70
|
| Rate for Payer: Aetna Medicare |
$6.36
|
| Rate for Payer: Aetna Medicare |
$10.29
|
| Rate for Payer: Aetna Medicare |
$6.28
|
| Rate for Payer: Aetna Medicare |
$5.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.31
|
| Rate for Payer: BCBS Complete |
$5.08
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS Complete |
$8.23
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$10.17
|
| Rate for Payer: Cash Price |
$9.27
|
| Rate for Payer: Cash Price |
$8.94
|
| Rate for Payer: Cash Price |
$8.94
|
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Cash Price |
$9.27
|
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Cash Price |
$10.17
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cofinity Advantage |
$8.11
|
| Rate for Payer: Cofinity Advantage |
$8.90
|
| Rate for Payer: Cofinity Advantage |
$8.79
|
| Rate for Payer: Cofinity Advantage |
$7.82
|
| Rate for Payer: Cofinity Advantage |
$12.21
|
| Rate for Payer: Cofinity Advantage |
$14.41
|
| Rate for Payer: Cofinity Advantage |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$9.97
|
| Rate for Payer: Cofinity Commercial |
$9.61
|
| Rate for Payer: Cofinity Commercial |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$15.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$10.05
|
| Rate for Payer: Healthscope Commercial |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$15.66
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Healthscope Commercial |
$11.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.09
|
| Rate for Payer: PHP Commercial |
$9.49
|
| Rate for Payer: PHP Commercial |
$10.67
|
| Rate for Payer: PHP Commercial |
$10.80
|
| Rate for Payer: PHP Commercial |
$14.79
|
| Rate for Payer: PHP Commercial |
$14.83
|
| Rate for Payer: PHP Commercial |
$17.49
|
| Rate for Payer: PHP Commercial |
$9.85
|
| Rate for Payer: Priority Health SBD |
$10.99
|
| Rate for Payer: Priority Health SBD |
$7.04
|
| Rate for Payer: Priority Health SBD |
$12.97
|
| Rate for Payer: Priority Health SBD |
$10.96
|
| Rate for Payer: Priority Health SBD |
$8.01
|
| Rate for Payer: Priority Health SBD |
$7.30
|
| Rate for Payer: Priority Health SBD |
$7.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.02
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Advantage |
$9.71
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.40
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health SBD |
$8.74
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$71.78
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.22 |
| Max. Negotiated Rate |
$64.60 |
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Advantage |
$61.41
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: Priority Health SBD |
$55.27
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$30.15
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$55.83
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$27.91
|
| Rate for Payer: Aetna Medicare |
$43.87
|
| Rate for Payer: Aetna Medicare |
$35.89
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS Complete |
$22.33
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Complete |
$28.71
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cofinity Advantage |
$61.41
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$55.27
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$7.12
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$2.42
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS Complete |
$1.14
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Complete |
$4.10
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$2.28
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$2.28
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$2.00
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$5.87
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$2.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.28
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.29
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$2.42
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$5.28
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$13.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$12.15 |
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$2.42
|
| Rate for Payer: Aetna Commercial |
$7.12
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$2.28
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cofinity Advantage |
$2.00
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$5.87
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$2.45
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.70
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.29
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$2.42
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: Priority Health SBD |
$5.28
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$6.46
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: Priority Health SBD |
$6.93
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
OP
|
$10.25
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: BCBS Complete |
$4.10
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$11.75
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$10.57 |
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Advantage |
$9.02
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health SBD |
$8.11
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$7.40
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$10.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna Medicare |
$6.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: BCBS Complete |
$5.15
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Advantage |
$9.02
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$8.11
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$95.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
118364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Medicare |
$47.85
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: BCBS Complete |
$38.28
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Advantage |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
118364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.19 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Advantage |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$60.29
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN NS CONTINUOUS INFUSION CUSTOM
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300070
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.19 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: Priority Health SBD |
$40.19
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN NS CONTINUOUS INFUSION CUSTOM
|
Facility
|
OP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300070
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
|
|
HEPARIN, PORCINE (PF) 5,000 UNIT/0.5 ML INJECTION SYRINGE
|
Facility
|
OP
|
$17.69
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
116333
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna Commercial |
$15.04
|
| Rate for Payer: Aetna Medicare |
$8.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.50
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS Trust/PPO |
$0.44
|
| Rate for Payer: BCN Commercial |
$0.44
|
| Rate for Payer: Cash Price |
$14.15
|
| Rate for Payer: Cash Price |
$14.15
|
| Rate for Payer: Cofinity Advantage |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.15
|
| Rate for Payer: Healthscope Commercial |
$15.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.27
|
| Rate for Payer: PHP Commercial |
$15.04
|
| Rate for Payer: Priority Health SBD |
$11.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$16,128.08
|
|
|
Service Code
|
APR-DRG 2794
|
| Min. Negotiated Rate |
$15,360.07 |
| Max. Negotiated Rate |
$16,128.08 |
| Rate for Payer: BCBS Complete |
$16,128.08
|
| Rate for Payer: Mclaren Medicaid |
$15,360.07
|
| Rate for Payer: Meridian Medicaid |
$16,128.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,360.07
|
| Rate for Payer: UHC Medicaid |
$15,360.07
|
| Rate for Payer: UHCCP Medicaid |
$15,360.07
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$3,135.95
|
|
|
Service Code
|
APR-DRG 2791
|
| Min. Negotiated Rate |
$2,986.62 |
| Max. Negotiated Rate |
$3,135.95 |
| Rate for Payer: BCBS Complete |
$3,135.95
|
| Rate for Payer: Mclaren Medicaid |
$2,986.62
|
| Rate for Payer: Meridian Medicaid |
$3,135.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,986.62
|
| Rate for Payer: UHC Medicaid |
$2,986.62
|
| Rate for Payer: UHCCP Medicaid |
$2,986.62
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$7,013.18
|
|
|
Service Code
|
APR-DRG 2793
|
| Min. Negotiated Rate |
$6,679.22 |
| Max. Negotiated Rate |
$7,013.18 |
| Rate for Payer: BCBS Complete |
$7,013.18
|
| Rate for Payer: Mclaren Medicaid |
$6,679.22
|
| Rate for Payer: Meridian Medicaid |
$7,013.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,679.22
|
| Rate for Payer: UHC Medicaid |
$6,679.22
|
| Rate for Payer: UHCCP Medicaid |
$6,679.22
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$4,557.73
|
|
|
Service Code
|
APR-DRG 2792
|
| Min. Negotiated Rate |
$4,340.70 |
| Max. Negotiated Rate |
$4,557.73 |
| Rate for Payer: BCBS Complete |
$4,557.73
|
| Rate for Payer: Mclaren Medicaid |
$4,340.70
|
| Rate for Payer: Meridian Medicaid |
$4,557.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,340.70
|
| Rate for Payer: UHC Medicaid |
$4,340.70
|
| Rate for Payer: UHCCP Medicaid |
$4,340.70
|
|
|
HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$275.27
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.42 |
| Max. Negotiated Rate |
$247.74 |
| Rate for Payer: Aetna Commercial |
$233.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.93
|
| Rate for Payer: Cash Price |
$220.22
|
| Rate for Payer: Cofinity Advantage |
$192.69
|
| Rate for Payer: Cofinity Commercial |
$236.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.22
|
| Rate for Payer: Healthscope Commercial |
$247.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.45
|
| Rate for Payer: PHP Commercial |
$233.98
|
| Rate for Payer: Priority Health SBD |
$173.42
|
|
|
HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$275.27
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116881
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$423.25 |
| Rate for Payer: Aetna Commercial |
$233.98
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.26
|
| Rate for Payer: BCBS Complete |
$77.00
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$389.23
|
| Rate for Payer: BCN Commercial |
$389.23
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$220.22
|
| Rate for Payer: Cash Price |
$220.22
|
| Rate for Payer: Cofinity Advantage |
$192.69
|
| Rate for Payer: Cofinity Commercial |
$236.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$247.74
|
| Rate for Payer: Mclaren Medicaid |
$73.33
|
| Rate for Payer: Mclaren Medicare |
$140.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Meridian Medicaid |
$147.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.98
|
| Rate for Payer: Nomi Health Commercial |
$420.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.45
|
| Rate for Payer: PACE Medicare |
$133.20
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Commercial |
$233.98
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$423.25
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Priority Health SBD |
$173.42
|
| Rate for Payer: Priority Health Tiered Network |
$338.60
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.93
|
| Rate for Payer: UHC Core |
$143.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$108.18
|
| Rate for Payer: UHC Medicaid |
$73.33
|
| Rate for Payer: UHCCP Medicaid |
$73.33
|
| Rate for Payer: VA VA |
$140.21
|
|
|
HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$2,174.88
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
91047
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,370.17 |
| Max. Negotiated Rate |
$1,957.39 |
| Rate for Payer: Aetna Commercial |
$1,848.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.67
|
| Rate for Payer: Cash Price |
$1,739.90
|
| Rate for Payer: Cofinity Advantage |
$1,522.42
|
| Rate for Payer: Cofinity Commercial |
$1,870.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,739.90
|
| Rate for Payer: Healthscope Commercial |
$1,957.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,848.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.16
|
| Rate for Payer: PHP Commercial |
$1,848.65
|
| Rate for Payer: Priority Health SBD |
$1,370.17
|
|
|
HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$2,174.88
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
91047
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$1,957.39 |
| Rate for Payer: Aetna Commercial |
$1,848.65
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.26
|
| Rate for Payer: BCBS Complete |
$77.00
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$389.23
|
| Rate for Payer: BCN Commercial |
$389.23
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$1,739.90
|
| Rate for Payer: Cash Price |
$1,739.90
|
| Rate for Payer: Cofinity Advantage |
$1,522.42
|
| Rate for Payer: Cofinity Commercial |
$1,870.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,739.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$1,957.39
|
| Rate for Payer: Mclaren Medicaid |
$73.33
|
| Rate for Payer: Mclaren Medicare |
$140.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Meridian Medicaid |
$147.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,848.65
|
| Rate for Payer: Nomi Health Commercial |
$420.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.16
|
| Rate for Payer: PACE Medicare |
$133.20
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Commercial |
$1,848.65
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$423.25
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Priority Health SBD |
$1,370.17
|
| Rate for Payer: Priority Health Tiered Network |
$338.60
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.42
|
| Rate for Payer: UHC Core |
$227.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$227.42
|
| Rate for Payer: UHC Medicaid |
$73.33
|
| Rate for Payer: UHCCP Medicaid |
$73.33
|
| Rate for Payer: VA VA |
$140.21
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP
|
Facility
|
OP
|
$158.26
|
|
|
Service Code
|
HCPCS 90746
|
| Hospital Charge Code |
118174
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.12 |
| Max. Negotiated Rate |
$177.81 |
| Rate for Payer: Aetna Commercial |
$134.52
|
| Rate for Payer: Aetna Medicare |
$79.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.87
|
| Rate for Payer: BCBS Complete |
$63.30
|
| Rate for Payer: BCBS Trust/PPO |
$177.81
|
| Rate for Payer: BCN Commercial |
$177.81
|
| Rate for Payer: Cash Price |
$126.61
|
| Rate for Payer: Cash Price |
$126.61
|
| Rate for Payer: Cofinity Advantage |
$110.78
|
| Rate for Payer: Cofinity Commercial |
$136.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.61
|
| Rate for Payer: Healthscope Commercial |
$142.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.69
|
| Rate for Payer: PHP Commercial |
$134.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.15
|
| Rate for Payer: Priority Health SBD |
$99.70
|
| Rate for Payer: Priority Health Tiered Network |
$60.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.00
|
| Rate for Payer: UHC Core |
$124.00
|
| Rate for Payer: UHC Exchange |
$124.00
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP
|
Facility
|
IP
|
$158.26
|
|
|
Service Code
|
HCPCS 90746
|
| Hospital Charge Code |
118174
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$99.70 |
| Max. Negotiated Rate |
$142.43 |
| Rate for Payer: Aetna Commercial |
$134.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.87
|
| Rate for Payer: Cash Price |
$126.61
|
| Rate for Payer: Cofinity Advantage |
$110.78
|
| Rate for Payer: Cofinity Commercial |
$136.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.61
|
| Rate for Payer: Healthscope Commercial |
$142.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.69
|
| Rate for Payer: PHP Commercial |
$134.52
|
| Rate for Payer: Priority Health SBD |
$99.70
|
|
