|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
NDC 51645078599
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Advantage |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health SBD |
$115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.60
|
| Rate for Payer: UHC Core |
$95.86
|
| Rate for Payer: UHC Exchange |
$72.31
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
NDC 10006070028
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.61 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: BCBS Complete |
$102.40
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health SBD |
$161.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.40
|
| Rate for Payer: UHC Core |
$133.38
|
| Rate for Payer: UHC Exchange |
$100.61
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
OP
|
$107.80
|
|
|
Service Code
|
NDC 64980033901
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.37 |
| Max. Negotiated Rate |
$97.02 |
| Rate for Payer: Aetna Commercial |
$91.63
|
| Rate for Payer: Aetna Medicare |
$53.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.07
|
| Rate for Payer: BCBS Complete |
$43.12
|
| Rate for Payer: Cash Price |
$86.24
|
| Rate for Payer: Cofinity Advantage |
$75.46
|
| Rate for Payer: Cofinity Commercial |
$92.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.24
|
| Rate for Payer: Healthscope Commercial |
$97.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.85
|
| Rate for Payer: PHP Commercial |
$91.63
|
| Rate for Payer: Priority Health SBD |
$67.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.07
|
| Rate for Payer: UHC Core |
$56.16
|
| Rate for Payer: UHC Exchange |
$42.37
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 64980033990
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Aetna Commercial |
$0.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.70
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cofinity Advantage |
$0.76
|
| Rate for Payer: Cofinity Commercial |
$0.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.86
|
| Rate for Payer: Healthscope Commercial |
$0.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.81
|
| Rate for Payer: PHP Commercial |
$0.92
|
| Rate for Payer: Priority Health SBD |
$0.68
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$173.88
|
|
|
Service Code
|
NDC 10006073038
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.54 |
| Max. Negotiated Rate |
$156.49 |
| Rate for Payer: Aetna Commercial |
$147.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.02
|
| Rate for Payer: Cash Price |
$139.10
|
| Rate for Payer: Cofinity Advantage |
$121.72
|
| Rate for Payer: Cofinity Commercial |
$149.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.10
|
| Rate for Payer: Healthscope Commercial |
$156.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.41
|
| Rate for Payer: PHP Commercial |
$147.80
|
| Rate for Payer: Priority Health SBD |
$109.54
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
OP
|
$176.00
|
|
|
Service Code
|
NDC 37864078599
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.17 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.40
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Advantage |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: Priority Health SBD |
$110.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.40
|
| Rate for Payer: UHC Core |
$91.70
|
| Rate for Payer: UHC Exchange |
$69.17
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
NDC 10006070028
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.28 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health SBD |
$161.28
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
NDC 51645078599
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.92 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Advantage |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health SBD |
$115.92
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$384.00
|
|
|
Service Code
|
NDC 60258017101
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$241.92 |
| Max. Negotiated Rate |
$345.60 |
| Rate for Payer: Aetna Commercial |
$326.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.60
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Advantage |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$330.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.20
|
| Rate for Payer: Healthscope Commercial |
$345.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.00
|
| Rate for Payer: PHP Commercial |
$326.40
|
| Rate for Payer: Priority Health SBD |
$241.92
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
OP
|
$173.88
|
|
|
Service Code
|
NDC 10006073038
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.33 |
| Max. Negotiated Rate |
$156.49 |
| Rate for Payer: Aetna Commercial |
$147.80
|
| Rate for Payer: Aetna Medicare |
$86.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.02
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: Cash Price |
$139.10
|
| Rate for Payer: Cofinity Advantage |
$121.72
|
| Rate for Payer: Cofinity Commercial |
$149.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.10
|
| Rate for Payer: Healthscope Commercial |
$156.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.41
|
| Rate for Payer: PHP Commercial |
$147.80
|
| Rate for Payer: Priority Health SBD |
$109.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.02
|
| Rate for Payer: UHC Core |
$90.59
|
| Rate for Payer: UHC Exchange |
$68.33
|
|
|
MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET
|
Facility
|
IP
|
$107.80
|
|
|
Service Code
|
NDC 64980033901
|
| Hospital Charge Code |
10491
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$97.02 |
| Rate for Payer: Aetna Commercial |
$91.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.07
|
| Rate for Payer: Cash Price |
$86.24
|
| Rate for Payer: Cofinity Advantage |
$75.46
|
| Rate for Payer: Cofinity Commercial |
$92.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.24
|
| Rate for Payer: Healthscope Commercial |
$97.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.85
|
| Rate for Payer: PHP Commercial |
$91.63
|
| Rate for Payer: Priority Health SBD |
$67.91
|
|
|
MAGNESIUM SULFATE 0.5 GRAM/ML (50 %) INJECTION (CODE)
|
Facility
|
IP
|
$21.44
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
163706
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$19.30 |
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Commercial |
$22.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.23
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cofinity Advantage |
$15.01
|
| Rate for Payer: Cofinity Advantage |
$18.55
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$22.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.15
|
| Rate for Payer: Healthscope Commercial |
$23.85
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.88
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: PHP Commercial |
$22.52
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$16.70
|
|
|
MAGNESIUM SULFATE 0.5 GRAM/ML (50 %) INJECTION (CODE)
|
Facility
|
OP
|
$26.50
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
163706
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$23.85 |
| Rate for Payer: Aetna Commercial |
$22.52
|
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Aetna Medicare |
$10.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.23
|
| Rate for Payer: BCBS Complete |
$10.60
|
| Rate for Payer: BCBS Complete |
$8.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cofinity Advantage |
$15.01
|
| Rate for Payer: Cofinity Advantage |
$18.55
|
| Rate for Payer: Cofinity Commercial |
$22.79
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.15
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$23.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.88
|
| Rate for Payer: PHP Commercial |
$22.52
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$16.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$87.40
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
16162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$78.66 |
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna Medicare |
$33.22
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.18
|
| Rate for Payer: BCBS Complete |
$26.57
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$53.14
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$53.14
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Advantage |
$46.50
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Cofinity Commercial |
$57.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$59.79
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.82
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: Priority Health SBD |
$41.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$87.40
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
16162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$78.66 |
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Cash Price |
$53.14
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Advantage |
$46.50
|
| Rate for Payer: Cofinity Commercial |
$57.13
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$59.79
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.82
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: Priority Health SBD |
$41.85
|
| Rate for Payer: Priority Health SBD |
$55.06
|
|
|
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$79.75
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117958
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$71.78 |
| Rate for Payer: Aetna Commercial |
$67.79
|
| Rate for Payer: Aetna Commercial |
$83.56
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Medicare |
$39.88
|
| Rate for Payer: Aetna Medicare |
$49.16
|
| Rate for Payer: Aetna Medicare |
$43.87
|
| Rate for Payer: Aetna Medicare |
$27.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.84
|
| Rate for Payer: BCBS Complete |
$39.32
|
| Rate for Payer: BCBS Complete |
$31.90
|
| Rate for Payer: BCBS Complete |
$22.33
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$63.80
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Cash Price |
$63.80
|
| Rate for Payer: Cofinity Advantage |
$68.82
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Advantage |
$61.41
|
| Rate for Payer: Cofinity Advantage |
$55.83
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$84.55
|
| Rate for Payer: Cofinity Commercial |
$68.58
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.80
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$88.48
|
| Rate for Payer: Healthscope Commercial |
$71.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.73
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Commercial |
$67.79
|
| Rate for Payer: PHP Commercial |
$83.56
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: Priority Health SBD |
$55.27
|
| Rate for Payer: Priority Health SBD |
$61.94
|
| Rate for Payer: Priority Health SBD |
$50.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$87.73
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117958
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.27 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Priority Health SBD |
$61.94
|
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Commercial |
$83.56
|
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Commercial |
$67.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Cash Price |
$63.80
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cofinity Advantage |
$61.41
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Advantage |
$68.82
|
| Rate for Payer: Cofinity Advantage |
$55.83
|
| Rate for Payer: Cofinity Commercial |
$84.55
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$68.58
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$88.48
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.81
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Commercial |
$67.79
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$83.56
|
| Rate for Payer: Priority Health SBD |
$50.24
|
| Rate for Payer: Priority Health SBD |
$55.27
|
| Rate for Payer: Priority Health SBD |
$35.17
|
|
|
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$19.61
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117869
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Aetna Commercial |
$16.67
|
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$44.26
|
| Rate for Payer: Aetna Commercial |
$15.33
|
| Rate for Payer: Aetna Commercial |
$24.53
|
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Aetna Medicare |
$9.80
|
| Rate for Payer: Aetna Medicare |
$11.84
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: Aetna Medicare |
$26.04
|
| Rate for Payer: Aetna Medicare |
$14.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.39
|
| Rate for Payer: BCBS Complete |
$9.47
|
| Rate for Payer: BCBS Complete |
$20.83
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Complete |
$7.84
|
| Rate for Payer: BCBS Complete |
$7.21
|
| Rate for Payer: BCBS Complete |
$11.54
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.09
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cash Price |
$15.69
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$41.66
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$41.66
|
| Rate for Payer: Cash Price |
$23.09
|
| Rate for Payer: Cash Price |
$15.69
|
| Rate for Payer: Cofinity Advantage |
$12.62
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Advantage |
$20.20
|
| Rate for Payer: Cofinity Advantage |
$36.45
|
| Rate for Payer: Cofinity Advantage |
$16.58
|
| Rate for Payer: Cofinity Advantage |
$13.73
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$16.86
|
| Rate for Payer: Cofinity Commercial |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$44.78
|
| Rate for Payer: Cofinity Commercial |
$24.82
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$46.86
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$25.97
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$17.65
|
| Rate for Payer: Healthscope Commercial |
$16.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.05
|
| Rate for Payer: PHP Commercial |
$24.53
|
| Rate for Payer: PHP Commercial |
$16.67
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Commercial |
$15.33
|
| Rate for Payer: PHP Commercial |
$44.26
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: Priority Health SBD |
$18.27
|
| Rate for Payer: Priority Health SBD |
$12.35
|
| Rate for Payer: Priority Health SBD |
$32.80
|
| Rate for Payer: Priority Health SBD |
$18.18
|
| Rate for Payer: Priority Health SBD |
$14.92
|
| Rate for Payer: Priority Health SBD |
$11.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$19.61
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
117869
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Aetna Commercial |
$16.67
|
| Rate for Payer: Aetna Commercial |
$24.53
|
| Rate for Payer: Aetna Commercial |
$44.26
|
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$15.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.76
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$15.69
|
| Rate for Payer: Cash Price |
$23.09
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$41.66
|
| Rate for Payer: Cash Price |
$14.42
|
| Rate for Payer: Cofinity Advantage |
$20.20
|
| Rate for Payer: Cofinity Advantage |
$12.62
|
| Rate for Payer: Cofinity Advantage |
$36.45
|
| Rate for Payer: Cofinity Advantage |
$13.73
|
| Rate for Payer: Cofinity Advantage |
$20.30
|
| Rate for Payer: Cofinity Advantage |
$16.58
|
| Rate for Payer: Cofinity Commercial |
$16.86
|
| Rate for Payer: Cofinity Commercial |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$44.78
|
| Rate for Payer: Cofinity Commercial |
$24.82
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.66
|
| Rate for Payer: Healthscope Commercial |
$16.23
|
| Rate for Payer: Healthscope Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$17.65
|
| Rate for Payer: Healthscope Commercial |
$25.97
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$46.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.64
|
| Rate for Payer: PHP Commercial |
$24.53
|
| Rate for Payer: PHP Commercial |
$16.67
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Commercial |
$15.33
|
| Rate for Payer: PHP Commercial |
$44.26
|
| Rate for Payer: Priority Health SBD |
$14.92
|
| Rate for Payer: Priority Health SBD |
$18.18
|
| Rate for Payer: Priority Health SBD |
$18.27
|
| Rate for Payer: Priority Health SBD |
$11.36
|
| Rate for Payer: Priority Health SBD |
$12.35
|
| Rate for Payer: Priority Health SBD |
$32.80
|
|
|
MAGNESIUM SULFATE 4.06 MEQ/ML (50 %) INJECTION (TPN COMPONENT)
|
Facility
|
IP
|
$227.50
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
180902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.32 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$193.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.88
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cofinity Advantage |
$159.25
|
| Rate for Payer: Cofinity Commercial |
$195.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.00
|
| Rate for Payer: Healthscope Commercial |
$204.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.62
|
| Rate for Payer: PHP Commercial |
$193.38
|
| Rate for Payer: Priority Health SBD |
$143.32
|
|
|
MAGNESIUM SULFATE 4.06 MEQ/ML (50 %) INJECTION (TPN COMPONENT)
|
Facility
|
OP
|
$227.50
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
180902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$193.38
|
| Rate for Payer: Aetna Medicare |
$113.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.88
|
| Rate for Payer: BCBS Complete |
$91.00
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cofinity Advantage |
$159.25
|
| Rate for Payer: Cofinity Commercial |
$195.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.00
|
| Rate for Payer: Healthscope Commercial |
$204.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.62
|
| Rate for Payer: PHP Commercial |
$193.38
|
| Rate for Payer: Priority Health SBD |
$143.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$228.03
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.66 |
| Max. Negotiated Rate |
$205.23 |
| Rate for Payer: Aetna Commercial |
$193.83
|
| Rate for Payer: Aetna Commercial |
$146.84
|
| Rate for Payer: Aetna Commercial |
$111.60
|
| Rate for Payer: Aetna Commercial |
$340.66
|
| Rate for Payer: Aetna Commercial |
$399.40
|
| Rate for Payer: Aetna Commercial |
$129.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.81
|
| Rate for Payer: Cash Price |
$105.03
|
| Rate for Payer: Cash Price |
$121.62
|
| Rate for Payer: Cash Price |
$320.62
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$138.20
|
| Rate for Payer: Cash Price |
$182.42
|
| Rate for Payer: Cofinity Advantage |
$280.55
|
| Rate for Payer: Cofinity Advantage |
$120.92
|
| Rate for Payer: Cofinity Advantage |
$159.62
|
| Rate for Payer: Cofinity Advantage |
$106.41
|
| Rate for Payer: Cofinity Advantage |
$91.90
|
| Rate for Payer: Cofinity Advantage |
$328.92
|
| Rate for Payer: Cofinity Commercial |
$404.10
|
| Rate for Payer: Cofinity Commercial |
$148.56
|
| Rate for Payer: Cofinity Commercial |
$130.74
|
| Rate for Payer: Cofinity Commercial |
$112.91
|
| Rate for Payer: Cofinity Commercial |
$344.67
|
| Rate for Payer: Cofinity Commercial |
$196.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.90
|
| Rate for Payer: Healthscope Commercial |
$205.23
|
| Rate for Payer: Healthscope Commercial |
$422.89
|
| Rate for Payer: Healthscope Commercial |
$360.70
|
| Rate for Payer: Healthscope Commercial |
$136.82
|
| Rate for Payer: Healthscope Commercial |
$155.47
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.41
|
| Rate for Payer: PHP Commercial |
$399.40
|
| Rate for Payer: PHP Commercial |
$111.60
|
| Rate for Payer: PHP Commercial |
$129.22
|
| Rate for Payer: PHP Commercial |
$193.83
|
| Rate for Payer: PHP Commercial |
$146.84
|
| Rate for Payer: PHP Commercial |
$340.66
|
| Rate for Payer: Priority Health SBD |
$108.83
|
| Rate for Payer: Priority Health SBD |
$143.66
|
| Rate for Payer: Priority Health SBD |
$252.49
|
| Rate for Payer: Priority Health SBD |
$296.02
|
| Rate for Payer: Priority Health SBD |
$95.77
|
| Rate for Payer: Priority Health SBD |
$82.71
|
|
|
MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$152.02
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$136.82 |
| Rate for Payer: Aetna Commercial |
$129.22
|
| Rate for Payer: Aetna Commercial |
$146.84
|
| Rate for Payer: Aetna Commercial |
$399.40
|
| Rate for Payer: Aetna Commercial |
$111.60
|
| Rate for Payer: Aetna Commercial |
$193.83
|
| Rate for Payer: Aetna Commercial |
$340.66
|
| Rate for Payer: Aetna Medicare |
$65.64
|
| Rate for Payer: Aetna Medicare |
$76.01
|
| Rate for Payer: Aetna Medicare |
$86.38
|
| Rate for Payer: Aetna Medicare |
$200.39
|
| Rate for Payer: Aetna Medicare |
$234.94
|
| Rate for Payer: Aetna Medicare |
$114.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.29
|
| Rate for Payer: BCBS Complete |
$69.10
|
| Rate for Payer: BCBS Complete |
$187.95
|
| Rate for Payer: BCBS Complete |
$160.31
|
| Rate for Payer: BCBS Complete |
$60.81
|
| Rate for Payer: BCBS Complete |
$52.52
|
| Rate for Payer: BCBS Complete |
$91.21
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$320.62
|
| Rate for Payer: Cash Price |
$182.42
|
| Rate for Payer: Cash Price |
$138.20
|
| Rate for Payer: Cash Price |
$105.03
|
| Rate for Payer: Cash Price |
$105.03
|
| Rate for Payer: Cash Price |
$121.62
|
| Rate for Payer: Cash Price |
$138.20
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$320.62
|
| Rate for Payer: Cash Price |
$375.90
|
| Rate for Payer: Cash Price |
$182.42
|
| Rate for Payer: Cash Price |
$121.62
|
| Rate for Payer: Cofinity Advantage |
$91.90
|
| Rate for Payer: Cofinity Advantage |
$280.55
|
| Rate for Payer: Cofinity Advantage |
$159.62
|
| Rate for Payer: Cofinity Advantage |
$328.92
|
| Rate for Payer: Cofinity Advantage |
$120.92
|
| Rate for Payer: Cofinity Advantage |
$106.41
|
| Rate for Payer: Cofinity Commercial |
$148.56
|
| Rate for Payer: Cofinity Commercial |
$130.74
|
| Rate for Payer: Cofinity Commercial |
$112.91
|
| Rate for Payer: Cofinity Commercial |
$404.10
|
| Rate for Payer: Cofinity Commercial |
$196.11
|
| Rate for Payer: Cofinity Commercial |
$344.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.62
|
| Rate for Payer: Healthscope Commercial |
$422.89
|
| Rate for Payer: Healthscope Commercial |
$360.70
|
| Rate for Payer: Healthscope Commercial |
$205.23
|
| Rate for Payer: Healthscope Commercial |
$155.47
|
| Rate for Payer: Healthscope Commercial |
$136.82
|
| Rate for Payer: Healthscope Commercial |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$375.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.41
|
| Rate for Payer: PHP Commercial |
$193.83
|
| Rate for Payer: PHP Commercial |
$129.22
|
| Rate for Payer: PHP Commercial |
$146.84
|
| Rate for Payer: PHP Commercial |
$111.60
|
| Rate for Payer: PHP Commercial |
$399.40
|
| Rate for Payer: PHP Commercial |
$340.66
|
| Rate for Payer: Priority Health SBD |
$252.49
|
| Rate for Payer: Priority Health SBD |
$95.77
|
| Rate for Payer: Priority Health SBD |
$296.02
|
| Rate for Payer: Priority Health SBD |
$143.66
|
| Rate for Payer: Priority Health SBD |
$108.83
|
| Rate for Payer: Priority Health SBD |
$82.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION
|
Facility
|
OP
|
$55.85
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4720
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$50.27 |
| Rate for Payer: Aetna Commercial |
$47.47
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Commercial |
$23.55
|
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Medicare |
$7.68
|
| Rate for Payer: Aetna Medicare |
$10.72
|
| Rate for Payer: Aetna Medicare |
$11.12
|
| Rate for Payer: Aetna Medicare |
$27.93
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.99
|
| Rate for Payer: BCBS Complete |
$22.34
|
| Rate for Payer: BCBS Complete |
$8.58
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS Complete |
$6.15
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: BCN Commercial |
$1.01
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cash Price |
$44.68
|
| Rate for Payer: Cash Price |
$44.68
|
| Rate for Payer: Cofinity Advantage |
$39.09
|
| Rate for Payer: Cofinity Advantage |
$19.39
|
| Rate for Payer: Cofinity Advantage |
$15.01
|
| Rate for Payer: Cofinity Advantage |
$10.76
|
| Rate for Payer: Cofinity Advantage |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$48.03
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.15
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$13.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.77
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Commercial |
$47.47
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: Priority Health SBD |
$14.02
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: Priority Health SBD |
$35.19
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$9.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Core |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Exchange |
$0.68
|
|
|
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION
|
Facility
|
IP
|
$55.85
|
|
|
Service Code
|
HCPCS J3475
|
| Hospital Charge Code |
4720
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.19 |
| Max. Negotiated Rate |
$50.27 |
| Rate for Payer: Aetna Commercial |
$47.47
|
| Rate for Payer: Aetna Commercial |
$18.22
|
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna Commercial |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.30
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cash Price |
$44.68
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Advantage |
$19.39
|
| Rate for Payer: Cofinity Advantage |
$15.57
|
| Rate for Payer: Cofinity Advantage |
$39.09
|
| Rate for Payer: Cofinity Advantage |
$10.76
|
| Rate for Payer: Cofinity Advantage |
$15.01
|
| Rate for Payer: Cofinity Commercial |
$48.03
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.68
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$13.83
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.89
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: PHP Commercial |
$47.47
|
| Rate for Payer: PHP Commercial |
$18.22
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: Priority Health SBD |
$14.02
|
| Rate for Payer: Priority Health SBD |
$13.51
|
| Rate for Payer: Priority Health SBD |
$9.68
|
| Rate for Payer: Priority Health SBD |
$35.19
|
|
