|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$295.78
|
|
|
Service Code
|
NDC 68084080521
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$116.24 |
| Max. Negotiated Rate |
$266.20 |
| Rate for Payer: Aetna Commercial |
$251.41
|
| Rate for Payer: Aetna Medicare |
$147.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.26
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: Cash Price |
$236.62
|
| Rate for Payer: Cofinity Advantage |
$207.05
|
| Rate for Payer: Cofinity Commercial |
$254.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.62
|
| Rate for Payer: Healthscope Commercial |
$266.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$221.84
|
| Rate for Payer: PHP Commercial |
$251.41
|
| Rate for Payer: Priority Health SBD |
$186.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.26
|
| Rate for Payer: UHC Core |
$154.10
|
| Rate for Payer: UHC Exchange |
$116.24
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.07 |
| Max. Negotiated Rate |
$170.10 |
| Rate for Payer: Aetna Commercial |
$160.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.85
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Advantage |
$132.30
|
| Rate for Payer: Cofinity Commercial |
$162.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.20
|
| Rate for Payer: Healthscope Commercial |
$170.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.75
|
| Rate for Payer: PHP Commercial |
$160.65
|
| Rate for Payer: Priority Health SBD |
$119.07
|
|
|
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 Advantage |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| 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: Opus (Opus Packaging Group) HMA |
$240.19
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health SBD |
$201.76
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$320.25
|
|
|
Service Code
|
NDC 00406114201
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.86 |
| 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 Advantage |
$224.18
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Healthscope Commercial |
$288.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.19
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health SBD |
$201.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.16
|
| Rate for Payer: UHC Core |
$166.85
|
| Rate for Payer: UHC Exchange |
$125.86
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$9.86
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.21 |
| Max. Negotiated Rate |
$8.87 |
| Rate for Payer: Aetna Commercial |
$8.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.41
|
| Rate for Payer: Cash Price |
$7.89
|
| Rate for Payer: Cofinity Advantage |
$6.90
|
| Rate for Payer: Cofinity Commercial |
$8.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.89
|
| Rate for Payer: Healthscope Commercial |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.39
|
| Rate for Payer: PHP Commercial |
$8.38
|
| Rate for Payer: Priority Health SBD |
$6.21
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$9.86
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$8.87 |
| Rate for Payer: Aetna Commercial |
$8.38
|
| Rate for Payer: Aetna Medicare |
$4.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.41
|
| Rate for Payer: BCBS Complete |
$3.94
|
| Rate for Payer: Cash Price |
$7.89
|
| Rate for Payer: Cofinity Advantage |
$6.90
|
| Rate for Payer: Cofinity Commercial |
$8.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.89
|
| Rate for Payer: Healthscope Commercial |
$8.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.39
|
| Rate for Payer: PHP Commercial |
$8.38
|
| Rate for Payer: Priority Health SBD |
$6.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$5.14
|
| Rate for Payer: UHC Exchange |
$3.87
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.28 |
| Max. Negotiated Rate |
$170.10 |
| Rate for Payer: Aetna Commercial |
$160.65
|
| Rate for Payer: Aetna Medicare |
$94.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.85
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Advantage |
$132.30
|
| Rate for Payer: Cofinity Commercial |
$162.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.20
|
| Rate for Payer: Healthscope Commercial |
$170.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$151.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.75
|
| Rate for Payer: PHP Commercial |
$160.65
|
| Rate for Payer: Priority Health SBD |
$119.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.85
|
| Rate for Payer: UHC Core |
$98.47
|
| Rate for Payer: UHC Exchange |
$74.28
|
|
|
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 |
$184.87 |
| 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 Advantage |
$329.28
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.80
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Priority Health SBD |
$296.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.76
|
| Rate for Payer: UHC Core |
$245.08
|
| Rate for Payer: UHC Exchange |
$184.87
|
|
|
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 Advantage |
$329.28
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| 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: Opus (Opus Packaging Group) HMA |
$352.80
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Priority Health SBD |
$296.35
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$543.90
|
|
|
Service Code
|
NDC 13811070810
|
| Hospital Charge Code |
28751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$213.75 |
| Max. Negotiated Rate |
$489.51 |
| Rate for Payer: Aetna Commercial |
$462.31
|
| Rate for Payer: Aetna Medicare |
$271.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.54
|
| Rate for Payer: BCBS Complete |
$217.56
|
| Rate for Payer: Cash Price |
$435.12
|
| Rate for Payer: Cofinity Advantage |
$380.73
|
| Rate for Payer: Cofinity Commercial |
$467.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.12
|
| Rate for Payer: Healthscope Commercial |
$489.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$435.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$462.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.93
|
| Rate for Payer: PHP Commercial |
$462.31
|
| Rate for Payer: Priority Health SBD |
$342.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.54
|
| Rate for Payer: UHC Core |
$283.37
|
| Rate for Payer: UHC Exchange |
$213.75
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$543.90
|
|
|
Service Code
|
NDC 13811070810
|
| Hospital Charge Code |
28751
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$342.66 |
| Max. Negotiated Rate |
$489.51 |
| Rate for Payer: Aetna Commercial |
$462.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.54
|
| Rate for Payer: Cash Price |
$435.12
|
| Rate for Payer: Cofinity Advantage |
$380.73
|
| Rate for Payer: Cofinity Commercial |
$467.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.12
|
| Rate for Payer: Healthscope Commercial |
$489.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$462.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.93
|
| Rate for Payer: PHP Commercial |
$462.31
|
| Rate for Payer: Priority Health SBD |
$342.66
|
|
|
METHYLPREDNISOLONE 32 MG TABLET
|
Facility
|
OP
|
$345.95
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$311.36 |
| Rate for Payer: Aetna Commercial |
$294.06
|
| Rate for Payer: Aetna Medicare |
$172.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.87
|
| Rate for Payer: BCBS Complete |
$138.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: Cash Price |
$276.76
|
| Rate for Payer: Cash Price |
$276.76
|
| Rate for Payer: Cofinity Advantage |
$242.16
|
| Rate for Payer: Cofinity Commercial |
$297.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.76
|
| Rate for Payer: Healthscope Commercial |
$311.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.46
|
| Rate for Payer: PHP Commercial |
$294.06
|
| Rate for Payer: Priority Health SBD |
$217.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
|
|
METHYLPREDNISOLONE 32 MG TABLET
|
Facility
|
IP
|
$345.95
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$217.95 |
| Max. Negotiated Rate |
$311.36 |
| Rate for Payer: Aetna Commercial |
$294.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.87
|
| Rate for Payer: Cash Price |
$276.76
|
| Rate for Payer: Cofinity Advantage |
$242.16
|
| Rate for Payer: Cofinity Commercial |
$297.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.76
|
| Rate for Payer: Healthscope Commercial |
$311.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.46
|
| Rate for Payer: PHP Commercial |
$294.06
|
| Rate for Payer: Priority Health SBD |
$217.95
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
IP
|
$510.24
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$321.45 |
| Max. Negotiated Rate |
$459.22 |
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Commercial |
$543.86
|
| Rate for Payer: Aetna Commercial |
$5.98
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Commercial |
$598.13
|
| 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) |
$415.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.39
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$511.87
|
| Rate for Payer: Cash Price |
$562.94
|
| Rate for Payer: Cofinity Advantage |
$198.17
|
| Rate for Payer: Cofinity Advantage |
$357.17
|
| Rate for Payer: Cofinity Advantage |
$492.58
|
| Rate for Payer: Cofinity Advantage |
$447.89
|
| Rate for Payer: Cofinity Advantage |
$4.93
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$605.16
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$550.26
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$562.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.63
|
| Rate for Payer: Healthscope Commercial |
$459.22
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$6.34
|
| Rate for Payer: Healthscope Commercial |
$633.31
|
| Rate for Payer: Healthscope Commercial |
$575.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$543.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.32
|
| Rate for Payer: PHP Commercial |
$5.98
|
| Rate for Payer: PHP Commercial |
$598.13
|
| Rate for Payer: PHP Commercial |
$543.86
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$4.44
|
| Rate for Payer: Priority Health SBD |
$443.32
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: Priority Health SBD |
$403.10
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
OP
|
$7.04
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Aetna Commercial |
$5.98
|
| Rate for Payer: Aetna Commercial |
$543.86
|
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Commercial |
$598.13
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Medicare |
$141.55
|
| Rate for Payer: Aetna Medicare |
$255.12
|
| Rate for Payer: Aetna Medicare |
$319.92
|
| Rate for Payer: Aetna Medicare |
$3.52
|
| Rate for Payer: Aetna Medicare |
$351.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.01
|
| Rate for Payer: BCBS Complete |
$2.82
|
| Rate for Payer: BCBS Complete |
$204.10
|
| Rate for Payer: BCBS Complete |
$255.94
|
| Rate for Payer: BCBS Complete |
$113.24
|
| Rate for Payer: BCBS Complete |
$281.47
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: Cash Price |
$562.94
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$511.87
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$511.87
|
| Rate for Payer: Cash Price |
$562.94
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Cofinity Advantage |
$4.93
|
| Rate for Payer: Cofinity Advantage |
$492.58
|
| Rate for Payer: Cofinity Advantage |
$357.17
|
| Rate for Payer: Cofinity Advantage |
$198.17
|
| Rate for Payer: Cofinity Advantage |
$447.89
|
| Rate for Payer: Cofinity Commercial |
$550.26
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$605.16
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$562.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.63
|
| 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 |
$459.22
|
| Rate for Payer: Healthscope Commercial |
$6.34
|
| Rate for Payer: Healthscope Commercial |
$633.31
|
| Rate for Payer: Healthscope Commercial |
$575.86
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$543.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.76
|
| Rate for Payer: PHP Commercial |
$543.86
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: PHP Commercial |
$5.98
|
| Rate for Payer: PHP Commercial |
$598.13
|
| Rate for Payer: Priority Health SBD |
$403.10
|
| Rate for Payer: Priority Health SBD |
$443.32
|
| Rate for Payer: Priority Health SBD |
$4.44
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$36.01
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$32.41 |
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$26.86
|
| Rate for Payer: Cofinity Advantage |
$23.50
|
| Rate for Payer: Cofinity Advantage |
$23.49
|
| Rate for Payer: Cofinity Advantage |
$25.21
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$28.87
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.85
|
| 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 |
$26.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$30.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.01
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: Priority Health SBD |
$21.15
|
| Rate for Payer: Priority Health SBD |
$21.14
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| 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
|
$36.01
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$32.41 |
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Aetna Medicare |
$13.51
|
| Rate for Payer: Aetna Medicare |
$16.78
|
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: Aetna Medicare |
$16.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS Complete |
$7.64
|
| Rate for Payer: BCBS Complete |
$13.43
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: Cash Price |
$26.86
|
| 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 |
$26.85
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cash Price |
$26.86
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cofinity Advantage |
$25.21
|
| Rate for Payer: Cofinity Advantage |
$23.50
|
| Rate for Payer: Cofinity Advantage |
$18.91
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$23.49
|
| Rate for Payer: Cofinity Commercial |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$28.87
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$30.21
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.18
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: Priority Health SBD |
$21.14
|
| Rate for Payer: Priority Health SBD |
$21.15
|
| Rate for Payer: Priority Health SBD |
$22.69
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Commercial |
$72.73
|
| Rate for Payer: Aetna Medicare |
$12.95
|
| Rate for Payer: Aetna Medicare |
$13.51
|
| Rate for Payer: Aetna Medicare |
$42.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.62
|
| Rate for Payer: BCBS Complete |
$34.23
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS Complete |
$10.81
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cofinity Advantage |
$18.91
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Advantage |
$59.90
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Cofinity Commercial |
$23.24
|
| Rate for Payer: Cofinity Commercial |
$73.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$77.01
|
| Rate for Payer: Healthscope Commercial |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.18
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$22.97
|
| Rate for Payer: PHP Commercial |
$72.73
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health SBD |
$53.91
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$27.02
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.02 |
| Max. Negotiated Rate |
$24.32 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Commercial |
$72.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.91
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Advantage |
$59.90
|
| Rate for Payer: Cofinity Commercial |
$73.59
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Cofinity Commercial |
$23.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Healthscope Commercial |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$77.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.27
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$72.73
|
| Rate for Payer: PHP Commercial |
$22.97
|
| Rate for Payer: Priority Health SBD |
$53.91
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health SBD |
$17.02
|
|
|
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 |
$46.08
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| 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) |
$92.04
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cofinity Advantage |
$24.14
|
| Rate for Payer: Cofinity Advantage |
$99.12
|
| Rate for Payer: Cofinity Advantage |
$37.95
|
| Rate for Payer: Cofinity Advantage |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| 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 |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.95
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: Priority Health SBD |
$34.15
|
| Rate for Payer: Priority Health SBD |
$21.73
|
| Rate for Payer: Priority Health SBD |
$89.21
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$190.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$171.54 |
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Medicare |
$95.30
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: Aetna Medicare |
$17.25
|
| Rate for Payer: Aetna Medicare |
$70.80
|
| 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) |
$22.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| Rate for Payer: BCBS Complete |
$21.68
|
| Rate for Payer: BCBS Complete |
$76.24
|
| Rate for Payer: BCBS Complete |
$56.64
|
| Rate for Payer: BCBS Complete |
$13.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$113.28
|
| 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 Advantage |
$37.95
|
| Rate for Payer: Cofinity Advantage |
$99.12
|
| Rate for Payer: Cofinity Advantage |
$24.14
|
| Rate for Payer: Cofinity Advantage |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| 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 |
$152.48
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.37
|
| 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 |
$120.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.66
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: Priority Health SBD |
$89.21
|
| Rate for Payer: Priority Health SBD |
$21.73
|
| Rate for Payer: Priority Health SBD |
$34.15
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$17.37
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$15.63 |
| Rate for Payer: Aetna Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna Medicare |
$8.69
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.32
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS Complete |
$6.95
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Advantage |
$12.16
|
| Rate for Payer: Cofinity Advantage |
$33.73
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: Priority Health SBD |
$30.35
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
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 Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Advantage |
$12.16
|
| Rate for Payer: Cofinity Advantage |
$33.73
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$30.35
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: Priority Health SBD |
$13.34
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$17.40
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.96 |
| Max. Negotiated Rate |
$15.66 |
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.33
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cofinity Advantage |
$12.18
|
| Rate for Payer: Cofinity Advantage |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$22.62
|
| Rate for Payer: Healthscope Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.85
|
| Rate for Payer: PHP Commercial |
$14.79
|
| Rate for Payer: PHP Commercial |
$21.36
|
| Rate for Payer: Priority Health SBD |
$10.96
|
| Rate for Payer: Priority Health SBD |
$15.83
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$25.13
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$22.62 |
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Medicare |
$12.56
|
| Rate for Payer: Aetna Medicare |
$8.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.33
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cofinity Advantage |
$12.18
|
| Rate for Payer: Cofinity Advantage |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$15.66
|
| Rate for Payer: Healthscope Commercial |
$22.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.85
|
| Rate for Payer: PHP Commercial |
$21.36
|
| Rate for Payer: PHP Commercial |
$14.79
|
| Rate for Payer: Priority Health SBD |
$10.96
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
|
