|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$86.07
|
|
|
Service Code
|
NDC 33342025666
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.83 |
| Max. Negotiated Rate |
$77.46 |
| Rate for Payer: Aetna Commercial |
$73.16
|
| Rate for Payer: Aetna Medicare |
$43.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.95
|
| Rate for Payer: BCBS Complete |
$34.43
|
| Rate for Payer: Cash Price |
$68.86
|
| Rate for Payer: Cofinity Advantage |
$60.25
|
| Rate for Payer: Cofinity Commercial |
$74.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.86
|
| Rate for Payer: Healthscope Commercial |
$77.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.55
|
| Rate for Payer: PHP Commercial |
$73.16
|
| Rate for Payer: Priority Health SBD |
$54.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.95
|
| Rate for Payer: UHC Core |
$44.84
|
| Rate for Payer: UHC Exchange |
$33.83
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$63.70
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$57.33 |
| Rate for Payer: Aetna Commercial |
$54.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.41
|
| Rate for Payer: Cash Price |
$50.96
|
| Rate for Payer: Cofinity Advantage |
$44.59
|
| Rate for Payer: Cofinity Commercial |
$54.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.96
|
| Rate for Payer: Healthscope Commercial |
$57.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.77
|
| Rate for Payer: PHP Commercial |
$54.15
|
| Rate for Payer: Priority Health SBD |
$40.13
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.89 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna Medicare |
$223.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: BCBS Complete |
$179.02
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Advantage |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$358.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.67
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health SBD |
$281.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.91
|
| Rate for Payer: UHC Core |
$233.18
|
| Rate for Payer: UHC Exchange |
$175.89
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$205.38 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna Medicare |
$261.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: BCBS Complete |
$209.04
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Advantage |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$418.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.94
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health SBD |
$329.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.68
|
| Rate for Payer: UHC Core |
$272.27
|
| Rate for Payer: UHC Exchange |
$205.38
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$329.23 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.68
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Advantage |
$365.81
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.94
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: Priority Health SBD |
$329.23
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$447.56
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$281.96 |
| Max. Negotiated Rate |
$402.80 |
| Rate for Payer: Aetna Commercial |
$380.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.91
|
| Rate for Payer: Cash Price |
$358.05
|
| Rate for Payer: Cofinity Advantage |
$313.29
|
| Rate for Payer: Cofinity Commercial |
$384.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.05
|
| Rate for Payer: Healthscope Commercial |
$402.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.67
|
| Rate for Payer: PHP Commercial |
$380.43
|
| Rate for Payer: Priority Health SBD |
$281.96
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$63.60
|
|
|
Service Code
|
NDC 68180067711
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.99 |
| Max. Negotiated Rate |
$57.24 |
| Rate for Payer: Aetna Commercial |
$54.06
|
| Rate for Payer: Aetna Medicare |
$31.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: Cash Price |
$50.88
|
| Rate for Payer: Cofinity Advantage |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$57.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.70
|
| Rate for Payer: PHP Commercial |
$54.06
|
| Rate for Payer: Priority Health SBD |
$40.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.34
|
| Rate for Payer: UHC Core |
$33.14
|
| Rate for Payer: UHC Exchange |
$24.99
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$351.02
|
|
|
Service Code
|
NDC 47781047013
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$221.14 |
| Max. Negotiated Rate |
$315.92 |
| Rate for Payer: Aetna Commercial |
$298.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.16
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Advantage |
$245.71
|
| Rate for Payer: Cofinity Commercial |
$301.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Healthscope Commercial |
$315.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.26
|
| Rate for Payer: PHP Commercial |
$298.37
|
| Rate for Payer: Priority Health SBD |
$221.14
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$82.61
|
|
|
Service Code
|
NDC 72205004411
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.47 |
| Max. Negotiated Rate |
$74.35 |
| Rate for Payer: Aetna Commercial |
$70.22
|
| Rate for Payer: Aetna Medicare |
$41.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: BCBS Complete |
$33.04
|
| Rate for Payer: Cash Price |
$66.09
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.09
|
| Rate for Payer: Healthscope Commercial |
$74.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.96
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: Priority Health SBD |
$52.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.70
|
| Rate for Payer: UHC Core |
$43.04
|
| Rate for Payer: UHC Exchange |
$32.47
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$351.02
|
|
|
Service Code
|
NDC 47781047013
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.95 |
| Max. Negotiated Rate |
$315.92 |
| Rate for Payer: Aetna Commercial |
$298.37
|
| Rate for Payer: Aetna Medicare |
$175.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.16
|
| Rate for Payer: BCBS Complete |
$140.41
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Advantage |
$245.71
|
| Rate for Payer: Cofinity Commercial |
$301.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Healthscope Commercial |
$315.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.26
|
| Rate for Payer: PHP Commercial |
$298.37
|
| Rate for Payer: Priority Health SBD |
$221.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.16
|
| Rate for Payer: UHC Core |
$182.88
|
| Rate for Payer: UHC Exchange |
$137.95
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$85.73
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.69 |
| Max. Negotiated Rate |
$77.16 |
| Rate for Payer: Aetna Commercial |
$72.87
|
| Rate for Payer: Aetna Medicare |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.72
|
| Rate for Payer: BCBS Complete |
$34.29
|
| Rate for Payer: Cash Price |
$68.58
|
| Rate for Payer: Cofinity Advantage |
$60.01
|
| Rate for Payer: Cofinity Commercial |
$73.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$77.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.30
|
| Rate for Payer: PHP Commercial |
$72.87
|
| Rate for Payer: Priority Health SBD |
$54.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.72
|
| Rate for Payer: UHC Core |
$44.67
|
| Rate for Payer: UHC Exchange |
$33.69
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$82.61
|
|
|
Service Code
|
NDC 72205004411
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.04 |
| Max. Negotiated Rate |
$74.35 |
| Rate for Payer: Aetna Commercial |
$70.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Cash Price |
$66.09
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.09
|
| Rate for Payer: Healthscope Commercial |
$74.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.96
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: Priority Health SBD |
$52.04
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$468.96
|
|
|
Service Code
|
NDC 42806055501
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$295.44 |
| Max. Negotiated Rate |
$422.06 |
| Rate for Payer: Aetna Commercial |
$398.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.82
|
| Rate for Payer: Cash Price |
$375.17
|
| Rate for Payer: Cofinity Advantage |
$328.27
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.17
|
| Rate for Payer: Healthscope Commercial |
$422.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.72
|
| Rate for Payer: PHP Commercial |
$398.62
|
| Rate for Payer: Priority Health SBD |
$295.44
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$275.25
|
|
|
Service Code
|
NDC 62332041510
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.17 |
| Max. Negotiated Rate |
$247.72 |
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: Aetna Medicare |
$137.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.91
|
| Rate for Payer: BCBS Complete |
$110.10
|
| Rate for Payer: Cash Price |
$220.20
|
| Rate for Payer: Cofinity Advantage |
$192.68
|
| Rate for Payer: Cofinity Commercial |
$236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.20
|
| Rate for Payer: Healthscope Commercial |
$247.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.44
|
| Rate for Payer: PHP Commercial |
$233.96
|
| Rate for Payer: Priority Health SBD |
$173.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.91
|
| Rate for Payer: UHC Core |
$143.41
|
| Rate for Payer: UHC Exchange |
$108.17
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$82.61
|
|
|
Service Code
|
NDC 64380079901
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.04 |
| Max. Negotiated Rate |
$74.35 |
| Rate for Payer: Aetna Commercial |
$70.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Cash Price |
$66.09
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.09
|
| Rate for Payer: Healthscope Commercial |
$74.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.96
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: Priority Health SBD |
$52.04
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$82.61
|
|
|
Service Code
|
NDC 64380079901
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.47 |
| Max. Negotiated Rate |
$74.35 |
| Rate for Payer: Aetna Commercial |
$70.22
|
| Rate for Payer: Aetna Medicare |
$41.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: BCBS Complete |
$33.04
|
| Rate for Payer: Cash Price |
$66.09
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.09
|
| Rate for Payer: Healthscope Commercial |
$74.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.96
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: Priority Health SBD |
$52.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.70
|
| Rate for Payer: UHC Core |
$43.04
|
| Rate for Payer: UHC Exchange |
$32.47
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$85.73
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.01 |
| Max. Negotiated Rate |
$77.16 |
| Rate for Payer: Aetna Commercial |
$72.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.72
|
| Rate for Payer: Cash Price |
$68.58
|
| Rate for Payer: Cofinity Advantage |
$60.01
|
| Rate for Payer: Cofinity Commercial |
$73.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$77.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.30
|
| Rate for Payer: PHP Commercial |
$72.87
|
| Rate for Payer: Priority Health SBD |
$54.01
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$522.63
|
|
|
Service Code
|
NDC 00004080085
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$205.39 |
| Max. Negotiated Rate |
$470.37 |
| Rate for Payer: Aetna Commercial |
$444.24
|
| Rate for Payer: Aetna Medicare |
$261.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.71
|
| Rate for Payer: BCBS Complete |
$209.05
|
| Rate for Payer: Cash Price |
$418.10
|
| Rate for Payer: Cofinity Advantage |
$365.84
|
| Rate for Payer: Cofinity Commercial |
$449.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.10
|
| Rate for Payer: Healthscope Commercial |
$470.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$418.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.97
|
| Rate for Payer: PHP Commercial |
$444.24
|
| Rate for Payer: Priority Health SBD |
$329.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.71
|
| Rate for Payer: UHC Core |
$272.29
|
| Rate for Payer: UHC Exchange |
$205.39
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$468.96
|
|
|
Service Code
|
NDC 42806055501
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.30 |
| Max. Negotiated Rate |
$422.06 |
| Rate for Payer: Aetna Commercial |
$398.62
|
| Rate for Payer: Aetna Medicare |
$234.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.82
|
| Rate for Payer: BCBS Complete |
$187.58
|
| Rate for Payer: Cash Price |
$375.17
|
| Rate for Payer: Cofinity Advantage |
$328.27
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.17
|
| Rate for Payer: Healthscope Commercial |
$422.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$375.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.72
|
| Rate for Payer: PHP Commercial |
$398.62
|
| Rate for Payer: Priority Health SBD |
$295.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.82
|
| Rate for Payer: UHC Core |
$244.33
|
| Rate for Payer: UHC Exchange |
$184.30
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$522.63
|
|
|
Service Code
|
NDC 00004080085
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$329.26 |
| Max. Negotiated Rate |
$470.37 |
| Rate for Payer: Aetna Commercial |
$444.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.71
|
| Rate for Payer: Cash Price |
$418.10
|
| Rate for Payer: Cofinity Advantage |
$365.84
|
| Rate for Payer: Cofinity Commercial |
$449.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.10
|
| Rate for Payer: Healthscope Commercial |
$470.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.97
|
| Rate for Payer: PHP Commercial |
$444.24
|
| Rate for Payer: Priority Health SBD |
$329.26
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$63.60
|
|
|
Service Code
|
NDC 68180067711
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.07 |
| Max. Negotiated Rate |
$57.24 |
| Rate for Payer: Aetna Commercial |
$54.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: Cash Price |
$50.88
|
| Rate for Payer: Cofinity Advantage |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$57.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.70
|
| Rate for Payer: PHP Commercial |
$54.06
|
| Rate for Payer: Priority Health SBD |
$40.07
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$275.25
|
|
|
Service Code
|
NDC 62332041510
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.41 |
| Max. Negotiated Rate |
$247.72 |
| Rate for Payer: Aetna Commercial |
$233.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.91
|
| Rate for Payer: Cash Price |
$220.20
|
| Rate for Payer: Cofinity Advantage |
$192.68
|
| Rate for Payer: Cofinity Commercial |
$236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.20
|
| Rate for Payer: Healthscope Commercial |
$247.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.44
|
| Rate for Payer: PHP Commercial |
$233.96
|
| Rate for Payer: Priority Health SBD |
$173.41
|
|
|
OSMOLITE 1.2 CONTINUOUS FEED
|
Facility
|
OP
|
$11.10
|
|
|
Service Code
|
NDC 70074062698
|
| Hospital Charge Code |
301611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$9.99 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna Medicare |
$5.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.21
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: Cash Price |
$8.88
|
| Rate for Payer: Cofinity Advantage |
$7.77
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.88
|
| Rate for Payer: Healthscope Commercial |
$9.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.32
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: Priority Health SBD |
$6.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.21
|
| Rate for Payer: UHC Core |
$5.78
|
| Rate for Payer: UHC Exchange |
$4.36
|
|
|
OSMOLITE 1.2 CONTINUOUS FEED
|
Facility
|
IP
|
$11.10
|
|
|
Service Code
|
NDC 70074062698
|
| Hospital Charge Code |
301611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$9.99 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.21
|
| Rate for Payer: Cash Price |
$8.88
|
| Rate for Payer: Cofinity Advantage |
$7.77
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.88
|
| Rate for Payer: Healthscope Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.32
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: Priority Health SBD |
$6.99
|
|
|
OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS
|
Facility
|
IP
|
$5,724.40
|
|
|
Service Code
|
APR-DRG 3442
|
| Min. Negotiated Rate |
$5,451.81 |
| Max. Negotiated Rate |
$5,724.40 |
| Rate for Payer: BCBS Complete |
$5,724.40
|
| Rate for Payer: Mclaren Medicaid |
$5,451.81
|
| Rate for Payer: Meridian Medicaid |
$5,724.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,451.81
|
| Rate for Payer: UHC Medicaid |
$5,451.81
|
| Rate for Payer: UHCCP Medicaid |
$5,451.81
|
|
