|
MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$34.75
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
116144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.45 |
| Max. Negotiated Rate |
$31.27 |
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna Medicare |
$17.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.59
|
| Rate for Payer: BCBS Complete |
$13.90
|
| Rate for Payer: BCBS Trust/PPO |
$20.44
|
| Rate for Payer: BCN Commercial |
$20.44
|
| Rate for Payer: Cash Price |
$27.80
|
| Rate for Payer: Cash Price |
$27.80
|
| Rate for Payer: Cofinity Advantage |
$24.32
|
| Rate for Payer: Cofinity Commercial |
$29.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$31.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.06
|
| Rate for Payer: PHP Commercial |
$29.54
|
| Rate for Payer: Priority Health SBD |
$21.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.45
|
| Rate for Payer: UHC Core |
$13.45
|
| Rate for Payer: UHC Exchange |
$13.45
|
|
|
MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$34.75
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
116144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.89 |
| Max. Negotiated Rate |
$31.27 |
| Rate for Payer: Aetna Commercial |
$29.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.59
|
| Rate for Payer: Cash Price |
$27.80
|
| Rate for Payer: Cofinity Advantage |
$24.32
|
| Rate for Payer: Cofinity Commercial |
$29.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$31.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.06
|
| Rate for Payer: PHP Commercial |
$29.54
|
| Rate for Payer: Priority Health SBD |
$21.89
|
|
|
MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
IP
|
$25.10
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
105637
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$22.59 |
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.32
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cofinity Advantage |
$17.57
|
| Rate for Payer: Cofinity Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$22.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.82
|
| Rate for Payer: PHP Commercial |
$21.34
|
| Rate for Payer: Priority Health SBD |
$15.81
|
|
|
MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
OP
|
$25.10
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
105637
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.19 |
| Max. Negotiated Rate |
$22.59 |
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna Medicare |
$12.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.32
|
| Rate for Payer: BCBS Complete |
$10.04
|
| Rate for Payer: BCBS Trust/PPO |
$9.41
|
| Rate for Payer: BCN Commercial |
$9.41
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cash Price |
$20.08
|
| Rate for Payer: Cofinity Advantage |
$17.57
|
| Rate for Payer: Cofinity Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.82
|
| Rate for Payer: PHP Commercial |
$21.34
|
| Rate for Payer: Priority Health SBD |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.19
|
| Rate for Payer: UHC Core |
$6.19
|
| Rate for Payer: UHC Exchange |
$6.19
|
|
|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$8,599.22
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$7,739.30 |
| Rate for Payer: Aetna Commercial |
$7,309.34
|
| Rate for Payer: Aetna Medicare |
$33.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,589.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.77
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$31.82
|
| Rate for Payer: BCBS Trust/PPO |
$79.98
|
| Rate for Payer: BCN Commercial |
$79.98
|
| Rate for Payer: BCN Medicare Advantage |
$31.82
|
| Rate for Payer: Cash Price |
$6,879.38
|
| Rate for Payer: Cash Price |
$6,879.38
|
| Rate for Payer: Cofinity Advantage |
$6,019.45
|
| Rate for Payer: Cofinity Commercial |
$7,395.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,879.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$7,739.30
|
| Rate for Payer: Mclaren Medicaid |
$16.64
|
| Rate for Payer: Mclaren Medicare |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.41
|
| Rate for Payer: Meridian Medicaid |
$33.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,309.34
|
| Rate for Payer: Nomi Health Commercial |
$95.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,449.41
|
| Rate for Payer: PACE Medicare |
$30.23
|
| Rate for Payer: PACE SWMI |
$31.82
|
| Rate for Payer: PHP Commercial |
$7,309.34
|
| Rate for Payer: PHP Medicare Advantage |
$31.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.63
|
| Rate for Payer: Priority Health Medicare |
$31.82
|
| Rate for Payer: Priority Health SBD |
$5,417.51
|
| Rate for Payer: Priority Health Tiered Network |
$78.90
|
| Rate for Payer: Railroad Medicare Medicare |
$31.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.62
|
| Rate for Payer: UHC Core |
$52.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.82
|
| Rate for Payer: UHC Exchange |
$52.62
|
| Rate for Payer: UHC Medicaid |
$16.64
|
| Rate for Payer: UHCCP Medicaid |
$16.64
|
| Rate for Payer: VA VA |
$31.82
|
|
|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$8,599.22
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5,417.51 |
| Max. Negotiated Rate |
$7,739.30 |
| Rate for Payer: Aetna Commercial |
$7,309.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,589.49
|
| Rate for Payer: Cash Price |
$6,879.38
|
| Rate for Payer: Cofinity Advantage |
$6,019.45
|
| Rate for Payer: Cofinity Commercial |
$7,395.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,879.38
|
| Rate for Payer: Healthscope Commercial |
$7,739.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,309.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,449.41
|
| Rate for Payer: PHP Commercial |
$7,309.34
|
| Rate for Payer: Priority Health SBD |
$5,417.51
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.34 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$13.34
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS Complete |
$7.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.03 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: Priority Health SBD |
$12.03
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$21.13
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$19.02 |
| Rate for Payer: Aetna Commercial |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cofinity Advantage |
$14.79
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.90
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.85
|
| Rate for Payer: PHP Commercial |
$17.96
|
| Rate for Payer: Priority Health SBD |
$13.31
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$21.13
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$19.02 |
| Rate for Payer: Aetna Commercial |
$17.96
|
| Rate for Payer: Aetna Medicare |
$10.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cofinity Advantage |
$14.79
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.90
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.85
|
| Rate for Payer: PHP Commercial |
$17.96
|
| Rate for Payer: Priority Health SBD |
$13.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.90
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$16.11 |
| Rate for Payer: Aetna Commercial |
$15.21
|
| Rate for Payer: Aetna Commercial |
$14.86
|
| Rate for Payer: Aetna Commercial |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cash Price |
$14.32
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Advantage |
$12.53
|
| Rate for Payer: Cofinity Advantage |
$12.24
|
| Rate for Payer: Cofinity Advantage |
$14.79
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Cofinity Commercial |
$15.03
|
| Rate for Payer: Cofinity Commercial |
$15.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.90
|
| Rate for Payer: Healthscope Commercial |
$15.73
|
| Rate for Payer: Healthscope Commercial |
$16.11
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.43
|
| Rate for Payer: PHP Commercial |
$14.86
|
| Rate for Payer: PHP Commercial |
$17.96
|
| Rate for Payer: PHP Commercial |
$15.21
|
| Rate for Payer: Priority Health SBD |
$13.31
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: Priority Health SBD |
$11.28
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.48
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$15.73 |
| Rate for Payer: Aetna Commercial |
$14.86
|
| Rate for Payer: Aetna Commercial |
$15.21
|
| Rate for Payer: Aetna Commercial |
$17.96
|
| Rate for Payer: Aetna Medicare |
$8.74
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna Medicare |
$10.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cash Price |
$14.32
|
| Rate for Payer: Cash Price |
$16.90
|
| Rate for Payer: Cash Price |
$14.32
|
| Rate for Payer: Cofinity Advantage |
$12.53
|
| Rate for Payer: Cofinity Advantage |
$12.24
|
| Rate for Payer: Cofinity Advantage |
$14.79
|
| Rate for Payer: Cofinity Commercial |
$15.03
|
| Rate for Payer: Cofinity Commercial |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$18.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: Healthscope Commercial |
$16.11
|
| Rate for Payer: Healthscope Commercial |
$15.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.85
|
| Rate for Payer: PHP Commercial |
$14.86
|
| Rate for Payer: PHP Commercial |
$15.21
|
| Rate for Payer: PHP Commercial |
$17.96
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: Priority Health SBD |
$13.31
|
| Rate for Payer: Priority Health SBD |
$11.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM IV 0.00001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
|
|
MEROPENEM IV 0.00001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM IV 0.0001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180553
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
|
|
MEROPENEM IV 0.0001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180553
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM IV 0.001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180554
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MEROPENEM IV 0.001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180554
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
|
|
MEROPENEM IV 0.01 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180555
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
|
|
MEROPENEM IV 0.01 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180555
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.96
|
| Rate for Payer: BCN Commercial |
$0.96
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$3,997.67
|
|
|
Service Code
|
NDC 58914050156
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,571.08 |
| Max. Negotiated Rate |
$3,597.90 |
| Rate for Payer: Aetna Commercial |
$3,398.02
|
| Rate for Payer: Aetna Medicare |
$1,998.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,598.49
|
| Rate for Payer: BCBS Complete |
$1,599.07
|
| Rate for Payer: Cash Price |
$3,198.14
|
| Rate for Payer: Cofinity Advantage |
$2,798.37
|
| Rate for Payer: Cofinity Commercial |
$3,438.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,198.14
|
| Rate for Payer: Healthscope Commercial |
$3,597.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,198.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,398.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,998.25
|
| Rate for Payer: PHP Commercial |
$3,398.02
|
| Rate for Payer: Priority Health SBD |
$2,518.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,598.49
|
| Rate for Payer: UHC Core |
$2,082.79
|
| Rate for Payer: UHC Exchange |
$1,571.08
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$3,997.67
|
|
|
Service Code
|
NDC 58914050156
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,518.53 |
| Max. Negotiated Rate |
$3,597.90 |
| Rate for Payer: Aetna Commercial |
$3,398.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,598.49
|
| Rate for Payer: Cash Price |
$3,198.14
|
| Rate for Payer: Cofinity Advantage |
$2,798.37
|
| Rate for Payer: Cofinity Commercial |
$3,438.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,198.14
|
| Rate for Payer: Healthscope Commercial |
$3,597.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,398.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,998.25
|
| Rate for Payer: PHP Commercial |
$3,398.02
|
| Rate for Payer: Priority Health SBD |
$2,518.53
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$344.10
|
|
|
Service Code
|
NDC 64980028203
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$216.78 |
| Max. Negotiated Rate |
$309.69 |
| Rate for Payer: Aetna Commercial |
$292.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.66
|
| Rate for Payer: Cash Price |
$275.28
|
| Rate for Payer: Cofinity Advantage |
$240.87
|
| Rate for Payer: Cofinity Commercial |
$295.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.28
|
| Rate for Payer: Healthscope Commercial |
$309.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.07
|
| Rate for Payer: PHP Commercial |
$292.49
|
| Rate for Payer: Priority Health SBD |
$216.78
|
|
