|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$13.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.44
|
| Rate for Payer: Priority Health SBD |
$16.90
|
|
|
HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$36.17
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10177
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.47 |
| Max. Negotiated Rate |
$32.55 |
| Rate for Payer: Aetna Commercial |
$30.74
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.51
|
| Rate for Payer: BCBS Complete |
$14.47
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$25.32
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$32.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: PHP Commercial |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.51
|
| Rate for Payer: Priority Health SBD |
$22.79
|
|
|
HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$36.17
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10177
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$32.55 |
| Rate for Payer: Aetna Commercial |
$30.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.51
|
| Rate for Payer: Cash Price |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$25.32
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.94
|
| Rate for Payer: Healthscope Commercial |
$32.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.74
|
| Rate for Payer: PHP Commercial |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.51
|
| Rate for Payer: Priority Health SBD |
$22.79
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$22.50
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$19.12
|
| Rate for Payer: Aetna Medicare |
$11.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.62
|
| Rate for Payer: BCBS Complete |
$9.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cofinity Commercial |
$15.75
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.00
|
| Rate for Payer: Healthscope Commercial |
$20.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.12
|
| Rate for Payer: PHP Commercial |
$19.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.62
|
| Rate for Payer: Priority Health SBD |
$14.18
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$16.58
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$14.92 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$22.64
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.10
|
| Rate for Payer: Cash Price |
$21.31
|
| Rate for Payer: Cash Price |
$13.26
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$22.79
|
| Rate for Payer: Cofinity Commercial |
$19.49
|
| Rate for Payer: Cofinity Commercial |
$10.98
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$14.11
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$18.65
|
| Rate for Payer: Cofinity Commercial |
$22.91
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$19.94
|
| Rate for Payer: Cofinity Commercial |
$24.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$14.92
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Healthscope Commercial |
$23.98
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$22.64
|
| Rate for Payer: PHP Commercial |
$14.09
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health SBD |
$16.78
|
| Rate for Payer: Priority Health SBD |
$12.70
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$17.54
|
| Rate for Payer: Priority Health SBD |
$9.88
|
| Rate for Payer: Priority Health SBD |
$17.95
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$15.69
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: Aetna Commercial |
$22.64
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Medicare |
$10.08
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Aetna Medicare |
$14.24
|
| Rate for Payer: Aetna Medicare |
$13.32
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna Medicare |
$7.84
|
| Rate for Payer: Aetna Medicare |
$13.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: BCBS Complete |
$11.14
|
| Rate for Payer: BCBS Complete |
$6.63
|
| Rate for Payer: BCBS Complete |
$8.06
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS Complete |
$10.66
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cash Price |
$22.79
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$21.31
|
| Rate for Payer: Cash Price |
$13.26
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$14.11
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$24.50
|
| Rate for Payer: Cofinity Commercial |
$19.94
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$19.49
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$10.98
|
| Rate for Payer: Cofinity Commercial |
$18.65
|
| Rate for Payer: Cofinity Commercial |
$22.91
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$14.92
|
| Rate for Payer: Healthscope Commercial |
$23.98
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Healthscope Commercial |
$25.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Commercial |
$22.64
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: PHP Commercial |
$14.09
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.32
|
| Rate for Payer: Priority Health SBD |
$17.54
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$17.95
|
| Rate for Payer: Priority Health SBD |
$12.70
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: Priority Health SBD |
$9.88
|
| Rate for Payer: Priority Health SBD |
$16.78
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$22.50
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$19.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.62
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$15.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.00
|
| Rate for Payer: Healthscope Commercial |
$20.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.12
|
| Rate for Payer: PHP Commercial |
$19.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.62
|
| Rate for Payer: Priority Health SBD |
$14.18
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
IP
|
$103.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.14 |
| Max. Negotiated Rate |
$93.06 |
| Rate for Payer: Aetna Commercial |
$87.89
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$72.38
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$88.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$87.89
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.21
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Priority Health SBD |
$65.14
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.38 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$87.89
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: BCBS Complete |
$41.36
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cofinity Commercial |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$72.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$87.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Priority Health SBD |
$65.14
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Commercial |
$87.89
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$37.87
|
| Rate for Payer: Aetna Medicare |
$48.20
|
| Rate for Payer: Aetna Medicare |
$45.90
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS Complete |
$30.30
|
| Rate for Payer: BCBS Complete |
$41.36
|
| Rate for Payer: BCBS Complete |
$38.56
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$72.38
|
| Rate for Payer: Cofinity Commercial |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$87.89
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.23
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: Priority Health SBD |
$65.14
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Priority Health SBD |
$47.72
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
IP
|
$103.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.14 |
| Max. Negotiated Rate |
$93.06 |
| Rate for Payer: Aetna Commercial |
$87.89
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.23
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Cofinity Commercial |
$72.38
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: PHP Commercial |
$87.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.21
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Priority Health SBD |
$65.14
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Priority Health SBD |
$47.72
|
| Rate for Payer: Priority Health SBD |
$60.73
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN
|
Facility
|
OP
|
$75.74
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15849
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.30 |
| Max. Negotiated Rate |
$68.17 |
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$48.20
|
| Rate for Payer: Aetna Medicare |
$37.87
|
| Rate for Payer: Aetna Medicare |
$45.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS Complete |
$30.30
|
| Rate for Payer: BCBS Complete |
$38.56
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Priority Health SBD |
$47.72
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15849
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$57.83 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$53.02
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.23
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Priority Health SBD |
$47.72
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$6.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.02
|
| Rate for Payer: BCBS Complete |
$5.55
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Cofinity Commercial |
$9.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.71
|
| 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: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.02
|
| Rate for Payer: Priority Health SBD |
$8.74
|
|
|
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 Commercial |
$9.71
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.71
|
| 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: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.02
|
| Rate for Payer: Priority Health SBD |
$8.74
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$12.55
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$11.29 |
| Rate for Payer: Aetna Commercial |
$10.67
|
| Rate for Payer: Aetna Commercial |
$9.85
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: Aetna Commercial |
$17.49
|
| Rate for Payer: Aetna Commercial |
$10.80
|
| Rate for Payer: Aetna Medicare |
$6.36
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna Medicare |
$6.28
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Aetna Medicare |
$10.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.16
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS Complete |
$8.23
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS Complete |
$5.08
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$9.27
|
| Rate for Payer: Cash Price |
$10.17
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$8.90
|
| Rate for Payer: Cofinity Commercial |
$11.65
|
| Rate for Payer: Cofinity Commercial |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Cofinity Commercial |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$9.97
|
| Rate for Payer: Cofinity Commercial |
$8.11
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$14.41
|
| Rate for Payer: Cofinity Commercial |
$8.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Healthscope Commercial |
$10.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: PHP Commercial |
$10.67
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$9.85
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: PHP Commercial |
$17.49
|
| Rate for Payer: PHP Commercial |
$10.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.04
|
| Rate for Payer: Priority Health SBD |
$12.97
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Priority Health SBD |
$7.91
|
| Rate for Payer: Priority Health SBD |
$7.30
|
| Rate for Payer: Priority Health SBD |
$8.01
|
| Rate for Payer: Priority Health SBD |
$10.70
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.49 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$9.85
|
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: Aetna Commercial |
$10.80
|
| Rate for Payer: Aetna Commercial |
$10.67
|
| Rate for Payer: Aetna Commercial |
$17.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Cash Price |
$9.27
|
| Rate for Payer: Cash Price |
$10.17
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cofinity Commercial |
$8.79
|
| Rate for Payer: Cofinity Commercial |
$10.79
|
| Rate for Payer: Cofinity Commercial |
$8.90
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$14.41
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$9.97
|
| Rate for Payer: Cofinity Commercial |
$8.11
|
| Rate for Payer: Cofinity Commercial |
$11.65
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Cofinity Commercial |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Healthscope Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.80
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: PHP Commercial |
$9.85
|
| Rate for Payer: PHP Commercial |
$10.80
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$17.49
|
| Rate for Payer: PHP Commercial |
$10.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.16
|
| Rate for Payer: Priority Health SBD |
$10.70
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Priority Health SBD |
$7.91
|
| Rate for Payer: Priority Health SBD |
$8.01
|
| Rate for Payer: Priority Health SBD |
$7.30
|
| Rate for Payer: Priority Health SBD |
$12.97
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15847
|
|
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 |
$47.46
|
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$50.25
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.29
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$35.17
|
|
|
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 |
$22.33 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Medicare |
$35.89
|
| Rate for Payer: Aetna Medicare |
$27.91
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Complete |
$22.33
|
| Rate for Payer: BCBS Complete |
$28.71
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$50.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| 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 |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$35.17
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$10.25
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| 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 |
$11.47
|
| Rate for Payer: Aetna Commercial |
$2.42
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: BCBS Complete |
$1.14
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$5.20
|
| 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 Complete |
$3.35
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$2.28
|
| Rate for Payer: Cofinity Commercial |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Cofinity Commercial |
$2.45
|
| Rate for Payer: Cofinity Commercial |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$7.17
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$9.45
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| 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 |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| 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: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$2.42
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.78
|
| 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 |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$8.51
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$10.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$2.42
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$7.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$8.40
|
| 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 |
$2.28
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cofinity Commercial |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$7.17
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$9.45
|
| Rate for Payer: Cofinity Commercial |
$2.45
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.10
|
| 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: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$2.42
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.66
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$5.28
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
IP
|
$10.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health SBD |
$6.62
|
|
|
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 |
$4.10 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| 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) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$4.10
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$7.17
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$8.19
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$11.75
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.70 |
| 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 Commercial |
$8.50
|
| Rate for Payer: Aetna Medicare |
$6.44
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Complete |
$5.15
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$9.02
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$7.00
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.02
|
| 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 |
$8.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$9.00
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.37
|
| Rate for Payer: Priority Health SBD |
$6.30
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$8.11
|
|
|
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 |
$8.50
|
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$9.02
|
| Rate for Payer: Cofinity Commercial |
$7.00
|
| Rate for Payer: Cofinity Commercial |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| 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 |
$9.00
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.50
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.83
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$6.30
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$8.11
|
|
