|
METHYLPHENIDATE 10 MG TABLET
|
Facility
|
OP
|
$456.75
|
|
|
Service Code
|
NDC 31722017401
|
| Hospital Charge Code |
4986
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$411.07 |
| Rate for Payer: Aetna Commercial |
$388.24
|
| Rate for Payer: Aetna Medicare |
$228.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.89
|
| Rate for Payer: BCBS Complete |
$182.70
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cofinity Commercial |
$319.73
|
| Rate for Payer: Cofinity Commercial |
$392.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$319.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.40
|
| Rate for Payer: Healthscope Commercial |
$411.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.24
|
| Rate for Payer: PHP Commercial |
$388.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.89
|
| Rate for Payer: Priority Health SBD |
$287.75
|
|
|
METHYLPHENIDATE 10 MG TABLET
|
Facility
|
IP
|
$456.75
|
|
|
Service Code
|
NDC 31722017401
|
| Hospital Charge Code |
4986
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.75 |
| Max. Negotiated Rate |
$411.07 |
| Rate for Payer: Aetna Commercial |
$388.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.89
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cofinity Commercial |
$319.73
|
| Rate for Payer: Cofinity Commercial |
$392.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$319.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.40
|
| Rate for Payer: Healthscope Commercial |
$411.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.24
|
| Rate for Payer: PHP Commercial |
$388.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.89
|
| Rate for Payer: Priority Health SBD |
$287.75
|
|
|
METHYLPHENIDATE 10 MG TABLET
|
Facility
|
IP
|
$425.25
|
|
|
Service Code
|
NDC 16729047901
|
| Hospital Charge Code |
4986
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$267.91 |
| Max. Negotiated Rate |
$382.73 |
| Rate for Payer: Aetna Commercial |
$361.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.41
|
| Rate for Payer: Cash Price |
$340.20
|
| Rate for Payer: Cofinity Commercial |
$297.68
|
| Rate for Payer: Cofinity Commercial |
$365.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.20
|
| Rate for Payer: Healthscope Commercial |
$382.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.46
|
| Rate for Payer: PHP Commercial |
$361.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.41
|
| Rate for Payer: Priority Health SBD |
$267.91
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$320.25
|
|
|
Service Code
|
NDC 00406114201
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.10 |
| Max. Negotiated Rate |
$288.23 |
| Rate for Payer: Aetna Commercial |
$272.21
|
| Rate for Payer: Aetna Medicare |
$160.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.16
|
| Rate for Payer: BCBS Complete |
$128.10
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Healthscope Commercial |
$288.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.21
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.16
|
| Rate for Payer: Priority Health SBD |
$201.76
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$394.59
|
|
|
Service Code
|
NDC 68084080521
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.59 |
| Max. Negotiated Rate |
$355.13 |
| Rate for Payer: Aetna Commercial |
$335.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.48
|
| Rate for Payer: Cash Price |
$315.67
|
| Rate for Payer: Cofinity Commercial |
$276.21
|
| Rate for Payer: Cofinity Commercial |
$339.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.67
|
| Rate for Payer: Healthscope Commercial |
$355.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.40
|
| Rate for Payer: PHP Commercial |
$335.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.48
|
| Rate for Payer: Priority Health SBD |
$248.59
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$13.16
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna Medicare |
$6.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.55
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.19
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.55
|
| Rate for Payer: Priority Health SBD |
$8.29
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$13.16
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.55
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.19
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.55
|
| Rate for Payer: Priority Health SBD |
$8.29
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$394.59
|
|
|
Service Code
|
NDC 68084080521
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.84 |
| Max. Negotiated Rate |
$355.13 |
| Rate for Payer: Aetna Commercial |
$335.40
|
| Rate for Payer: Aetna Medicare |
$197.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.48
|
| Rate for Payer: BCBS Complete |
$157.84
|
| Rate for Payer: Cash Price |
$315.67
|
| Rate for Payer: Cofinity Commercial |
$276.21
|
| Rate for Payer: Cofinity Commercial |
$339.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.67
|
| Rate for Payer: Healthscope Commercial |
$355.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.40
|
| Rate for Payer: PHP Commercial |
$335.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.48
|
| Rate for Payer: Priority Health SBD |
$248.59
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.20
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.80
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health SBD |
$105.84
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$320.25
|
|
|
Service Code
|
NDC 00406114201
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$201.76 |
| Max. Negotiated Rate |
$288.23 |
| Rate for Payer: Aetna Commercial |
$272.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.16
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Healthscope Commercial |
$288.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.21
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.16
|
| Rate for Payer: Priority Health SBD |
$201.76
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.84 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.80
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health SBD |
$105.84
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$470.40
|
|
|
Service Code
|
NDC 13811070610
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$188.16 |
| Max. Negotiated Rate |
$423.36 |
| Rate for Payer: Aetna Commercial |
$399.84
|
| Rate for Payer: Aetna Medicare |
$235.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.76
|
| Rate for Payer: BCBS Complete |
$188.16
|
| Rate for Payer: Cash Price |
$376.32
|
| Rate for Payer: Cofinity Commercial |
$329.28
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.84
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.76
|
| Rate for Payer: Priority Health SBD |
$296.35
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$470.40
|
|
|
Service Code
|
NDC 13811070610
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$296.35 |
| Max. Negotiated Rate |
$423.36 |
| Rate for Payer: Aetna Commercial |
$399.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.76
|
| Rate for Payer: Cash Price |
$376.32
|
| Rate for Payer: Cofinity Commercial |
$329.28
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.84
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.76
|
| Rate for Payer: Priority Health SBD |
$296.35
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$506.80
|
|
|
Service Code
|
NDC 13811070810
|
| Hospital Charge Code |
28751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$202.72 |
| Max. Negotiated Rate |
$456.12 |
| Rate for Payer: Aetna Commercial |
$430.78
|
| Rate for Payer: Aetna Medicare |
$253.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.42
|
| Rate for Payer: BCBS Complete |
$202.72
|
| Rate for Payer: Cash Price |
$405.44
|
| Rate for Payer: Cofinity Commercial |
$354.76
|
| Rate for Payer: Cofinity Commercial |
$435.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$354.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.44
|
| Rate for Payer: Healthscope Commercial |
$456.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.78
|
| Rate for Payer: PHP Commercial |
$430.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.42
|
| Rate for Payer: Priority Health SBD |
$319.28
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$506.80
|
|
|
Service Code
|
NDC 13811070810
|
| Hospital Charge Code |
28751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$319.28 |
| Max. Negotiated Rate |
$456.12 |
| Rate for Payer: Aetna Commercial |
$430.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.42
|
| Rate for Payer: Cash Price |
$405.44
|
| Rate for Payer: Cofinity Commercial |
$354.76
|
| Rate for Payer: Cofinity Commercial |
$435.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$354.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.44
|
| Rate for Payer: Healthscope Commercial |
$456.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.78
|
| Rate for Payer: PHP Commercial |
$430.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.42
|
| Rate for Payer: Priority Health SBD |
$319.28
|
|
|
METHYLPREDNISOLONE 32 MG TABLET
|
Facility
|
OP
|
$294.34
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$117.74 |
| Max. Negotiated Rate |
$264.91 |
| Rate for Payer: Aetna Commercial |
$250.19
|
| Rate for Payer: Aetna Medicare |
$147.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.32
|
| Rate for Payer: BCBS Complete |
$117.74
|
| Rate for Payer: Cash Price |
$235.47
|
| Rate for Payer: Cofinity Commercial |
$206.04
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$206.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.47
|
| Rate for Payer: Healthscope Commercial |
$264.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.19
|
| Rate for Payer: PHP Commercial |
$250.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.32
|
| Rate for Payer: Priority Health SBD |
$185.43
|
|
|
METHYLPREDNISOLONE 32 MG TABLET
|
Facility
|
IP
|
$294.34
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$185.43 |
| Max. Negotiated Rate |
$264.91 |
| Rate for Payer: Aetna Commercial |
$250.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.32
|
| Rate for Payer: Cash Price |
$235.47
|
| Rate for Payer: Cofinity Commercial |
$206.04
|
| Rate for Payer: Cofinity Commercial |
$253.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$206.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.47
|
| Rate for Payer: Healthscope Commercial |
$264.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.19
|
| Rate for Payer: PHP Commercial |
$250.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.32
|
| Rate for Payer: Priority Health SBD |
$185.43
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
IP
|
$716.64
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$451.48 |
| Max. Negotiated Rate |
$644.98 |
| Rate for Payer: Aetna Commercial |
$609.14
|
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Commercial |
$6.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.82
|
| Rate for Payer: Cash Price |
$573.31
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$5.74
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cofinity Commercial |
$5.02
|
| Rate for Payer: Cofinity Commercial |
$6.17
|
| Rate for Payer: Cofinity Commercial |
$198.17
|
| Rate for Payer: Cofinity Commercial |
$357.17
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$501.65
|
| Rate for Payer: Cofinity Commercial |
$616.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$644.98
|
| Rate for Payer: Healthscope Commercial |
$459.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$609.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$609.14
|
| Rate for Payer: PHP Commercial |
$6.09
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health SBD |
$451.48
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$4.52
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
OP
|
$716.64
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$286.66 |
| Max. Negotiated Rate |
$644.98 |
| Rate for Payer: Aetna Commercial |
$609.14
|
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Commercial |
$6.09
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Aetna Medicare |
$358.32
|
| Rate for Payer: Aetna Medicare |
$255.12
|
| Rate for Payer: Aetna Medicare |
$141.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.66
|
| Rate for Payer: BCBS Complete |
$113.24
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS Complete |
$204.10
|
| Rate for Payer: BCBS Complete |
$286.66
|
| Rate for Payer: Cash Price |
$5.74
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$573.31
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$6.17
|
| Rate for Payer: Cofinity Commercial |
$501.65
|
| Rate for Payer: Cofinity Commercial |
$5.02
|
| Rate for Payer: Cofinity Commercial |
$616.31
|
| Rate for Payer: Cofinity Commercial |
$198.17
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$357.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$573.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$459.22
|
| Rate for Payer: Healthscope Commercial |
$644.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$609.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$6.09
|
| Rate for Payer: PHP Commercial |
$609.14
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.66
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: Priority Health SBD |
$451.48
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$4.52
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
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 |
$22.96
|
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$21.44
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.91
|
| Rate for Payer: Priority Health SBD |
$19.30
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Priority Health SBD |
$19.29
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: Priority Health SBD |
$22.69
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$30.62
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$27.56 |
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$21.44
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.41
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health SBD |
$19.29
|
| Rate for Payer: Priority Health SBD |
$19.30
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Priority Health SBD |
$22.69
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$36.89
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$33.20 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$29.51
|
| Rate for Payer: Cash Price |
$29.51
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Cofinity Commercial |
$18.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$33.20
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Commercial |
$31.36
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.84
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health SBD |
$23.24
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.98
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$29.51
|
| Rate for Payer: Cofinity Commercial |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.51
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Healthscope Commercial |
$33.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$31.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.84
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health SBD |
$23.24
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$34.49
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.42
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.89
|
| Rate for Payer: Priority Health SBD |
$21.73
|
| Rate for Payer: Priority Health SBD |
$89.21
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: Priority Health SBD |
$34.15
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$141.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$127.44 |
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.89
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$34.15
|
| Rate for Payer: Priority Health SBD |
$89.21
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: Priority Health SBD |
$21.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.12
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
|
