|
OXYMETAZOLINE 0.05 % NASAL SPRAY
|
Facility
|
OP
|
$10.53
|
|
|
Service Code
|
NDC 00904700635
|
| Hospital Charge Code |
5943
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$9.48 |
| Rate for Payer: Aetna Commercial |
$8.95
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.84
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cofinity Advantage |
$7.37
|
| Rate for Payer: Cofinity Commercial |
$9.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.42
|
| Rate for Payer: Healthscope Commercial |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.90
|
| Rate for Payer: PHP Commercial |
$8.95
|
| Rate for Payer: Priority Health SBD |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.84
|
| Rate for Payer: UHC Core |
$5.49
|
| Rate for Payer: UHC Exchange |
$4.14
|
|
|
OXYMETAZOLINE 0.05 % NASAL SPRAY
|
Facility
|
OP
|
$9.32
|
|
|
Service Code
|
NDC 00904742730
|
| Hospital Charge Code |
5943
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$8.39 |
| Rate for Payer: Aetna Commercial |
$7.92
|
| Rate for Payer: Aetna Medicare |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.06
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Cofinity Advantage |
$6.52
|
| Rate for Payer: Cofinity Commercial |
$8.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.46
|
| Rate for Payer: Healthscope Commercial |
$8.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.99
|
| Rate for Payer: PHP Commercial |
$7.92
|
| Rate for Payer: Priority Health SBD |
$5.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.06
|
| Rate for Payer: UHC Core |
$4.86
|
| Rate for Payer: UHC Exchange |
$3.66
|
|
|
OXYMETAZOLINE 0.05 % NASAL SPRAY
|
Facility
|
IP
|
$9.32
|
|
|
Service Code
|
NDC 00904742730
|
| Hospital Charge Code |
5943
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$8.39 |
| Rate for Payer: Aetna Commercial |
$7.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.06
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Cofinity Advantage |
$6.52
|
| Rate for Payer: Cofinity Commercial |
$8.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.46
|
| Rate for Payer: Healthscope Commercial |
$8.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.99
|
| Rate for Payer: PHP Commercial |
$7.92
|
| Rate for Payer: Priority Health SBD |
$5.87
|
|
|
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$728.19
|
|
|
Service Code
|
HCPCS J2590
|
| Hospital Charge Code |
5944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$458.76 |
| Max. Negotiated Rate |
$655.37 |
| Rate for Payer: Aetna Commercial |
$618.96
|
| Rate for Payer: Aetna Commercial |
$11.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.50
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cash Price |
$582.55
|
| Rate for Payer: Cofinity Advantage |
$509.73
|
| Rate for Payer: Cofinity Advantage |
$9.16
|
| Rate for Payer: Cofinity Commercial |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$626.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.46
|
| Rate for Payer: Healthscope Commercial |
$655.37
|
| Rate for Payer: Healthscope Commercial |
$11.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$618.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.14
|
| Rate for Payer: PHP Commercial |
$11.12
|
| Rate for Payer: PHP Commercial |
$618.96
|
| Rate for Payer: Priority Health SBD |
$458.76
|
| Rate for Payer: Priority Health SBD |
$8.24
|
|
|
OXYTOCIN 10 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$728.19
|
|
|
Service Code
|
HCPCS J2590
|
| Hospital Charge Code |
5944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$655.37 |
| Rate for Payer: Aetna Commercial |
$618.96
|
| Rate for Payer: Aetna Commercial |
$11.12
|
| Rate for Payer: Aetna Medicare |
$6.54
|
| Rate for Payer: Aetna Medicare |
$364.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.50
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS Complete |
$291.28
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.22
|
| Rate for Payer: Cash Price |
$582.55
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cash Price |
$582.55
|
| Rate for Payer: Cash Price |
$10.46
|
| Rate for Payer: Cofinity Advantage |
$509.73
|
| Rate for Payer: Cofinity Advantage |
$9.16
|
| Rate for Payer: Cofinity Commercial |
$626.24
|
| Rate for Payer: Cofinity Commercial |
$11.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.55
|
| Rate for Payer: Healthscope Commercial |
$11.77
|
| Rate for Payer: Healthscope Commercial |
$655.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$582.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$618.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.81
|
| Rate for Payer: PHP Commercial |
$618.96
|
| Rate for Payer: PHP Commercial |
$11.12
|
| Rate for Payer: Priority Health SBD |
$458.76
|
| Rate for Payer: Priority Health SBD |
$8.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.44
|
| Rate for Payer: UHC Core |
$4.44
|
| Rate for Payer: UHC Core |
$4.44
|
| Rate for Payer: UHC Exchange |
$4.44
|
| Rate for Payer: UHC Exchange |
$4.44
|
|
|
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$67.19
|
|
|
Service Code
|
HCPCS J2590
|
| Hospital Charge Code |
115673
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.33 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$112.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.94
|
| Rate for Payer: Cash Price |
$105.77
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Advantage |
$47.03
|
| Rate for Payer: Cofinity Advantage |
$92.55
|
| Rate for Payer: Cofinity Commercial |
$113.70
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.77
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: PHP Commercial |
$112.38
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$83.29
|
|
|
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$67.19
|
|
|
Service Code
|
HCPCS J2590
|
| Hospital Charge Code |
115673
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$112.38
|
| Rate for Payer: Aetna Medicare |
$66.11
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.94
|
| Rate for Payer: BCBS Complete |
$52.88
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.22
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$105.77
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$105.77
|
| Rate for Payer: Cofinity Advantage |
$47.03
|
| Rate for Payer: Cofinity Advantage |
$92.55
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$113.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$118.99
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.16
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$112.38
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$83.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.44
|
| Rate for Payer: UHC Core |
$4.44
|
| Rate for Payer: UHC Core |
$4.44
|
| Rate for Payer: UHC Exchange |
$4.44
|
| Rate for Payer: UHC Exchange |
$4.44
|
|
|
PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
IP
|
$513.38
|
|
|
Service Code
|
HCPCS J9267
|
| Hospital Charge Code |
10843
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$323.43 |
| Max. Negotiated Rate |
$462.04 |
| Rate for Payer: Aetna Commercial |
$436.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.70
|
| Rate for Payer: Cash Price |
$410.70
|
| Rate for Payer: Cofinity Advantage |
$359.37
|
| Rate for Payer: Cofinity Commercial |
$441.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.70
|
| Rate for Payer: Healthscope Commercial |
$462.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$385.04
|
| Rate for Payer: PHP Commercial |
$436.37
|
| Rate for Payer: Priority Health SBD |
$323.43
|
|
|
PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
OP
|
$358.24
|
|
|
Service Code
|
HCPCS J9267
|
| Hospital Charge Code |
10843
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$322.42 |
| Rate for Payer: Aetna Commercial |
$304.50
|
| Rate for Payer: Aetna Commercial |
$303.64
|
| Rate for Payer: Aetna Commercial |
$327.16
|
| Rate for Payer: Aetna Commercial |
$945.47
|
| Rate for Payer: Aetna Commercial |
$402.17
|
| Rate for Payer: Aetna Commercial |
$302.76
|
| Rate for Payer: Aetna Commercial |
$436.37
|
| Rate for Payer: Aetna Medicare |
$178.61
|
| Rate for Payer: Aetna Medicare |
$178.09
|
| Rate for Payer: Aetna Medicare |
$179.12
|
| Rate for Payer: Aetna Medicare |
$556.16
|
| Rate for Payer: Aetna Medicare |
$256.69
|
| Rate for Payer: Aetna Medicare |
$192.44
|
| Rate for Payer: Aetna Medicare |
$236.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.86
|
| Rate for Payer: BCBS Complete |
$444.93
|
| Rate for Payer: BCBS Complete |
$153.96
|
| Rate for Payer: BCBS Complete |
$205.35
|
| Rate for Payer: BCBS Complete |
$142.48
|
| Rate for Payer: BCBS Complete |
$143.30
|
| Rate for Payer: BCBS Complete |
$142.89
|
| Rate for Payer: BCBS Complete |
$189.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Cash Price |
$889.86
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Cash Price |
$378.51
|
| Rate for Payer: Cash Price |
$285.78
|
| Rate for Payer: Cash Price |
$378.51
|
| Rate for Payer: Cash Price |
$284.95
|
| Rate for Payer: Cash Price |
$307.91
|
| Rate for Payer: Cash Price |
$284.95
|
| Rate for Payer: Cash Price |
$889.86
|
| Rate for Payer: Cash Price |
$307.91
|
| Rate for Payer: Cash Price |
$410.70
|
| Rate for Payer: Cash Price |
$285.78
|
| Rate for Payer: Cash Price |
$410.70
|
| Rate for Payer: Cofinity Advantage |
$778.62
|
| Rate for Payer: Cofinity Advantage |
$249.33
|
| Rate for Payer: Cofinity Advantage |
$250.05
|
| Rate for Payer: Cofinity Advantage |
$250.77
|
| Rate for Payer: Cofinity Advantage |
$269.42
|
| Rate for Payer: Cofinity Advantage |
$331.20
|
| Rate for Payer: Cofinity Advantage |
$359.37
|
| Rate for Payer: Cofinity Commercial |
$441.51
|
| Rate for Payer: Cofinity Commercial |
$306.32
|
| Rate for Payer: Cofinity Commercial |
$956.60
|
| Rate for Payer: Cofinity Commercial |
$331.01
|
| Rate for Payer: Cofinity Commercial |
$307.21
|
| Rate for Payer: Cofinity Commercial |
$308.09
|
| Rate for Payer: Cofinity Commercial |
$406.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.91
|
| Rate for Payer: Healthscope Commercial |
$346.40
|
| Rate for Payer: Healthscope Commercial |
$321.50
|
| Rate for Payer: Healthscope Commercial |
$322.42
|
| Rate for Payer: Healthscope Commercial |
$462.04
|
| Rate for Payer: Healthscope Commercial |
$320.57
|
| Rate for Payer: Healthscope Commercial |
$1,001.09
|
| Rate for Payer: Healthscope Commercial |
$425.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$889.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$834.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$385.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.92
|
| Rate for Payer: PHP Commercial |
$436.37
|
| Rate for Payer: PHP Commercial |
$302.76
|
| Rate for Payer: PHP Commercial |
$304.50
|
| Rate for Payer: PHP Commercial |
$327.16
|
| Rate for Payer: PHP Commercial |
$402.17
|
| Rate for Payer: PHP Commercial |
$945.47
|
| Rate for Payer: PHP Commercial |
$303.64
|
| Rate for Payer: Priority Health SBD |
$225.69
|
| Rate for Payer: Priority Health SBD |
$242.48
|
| Rate for Payer: Priority Health SBD |
$700.76
|
| Rate for Payer: Priority Health SBD |
$298.08
|
| Rate for Payer: Priority Health SBD |
$224.40
|
| Rate for Payer: Priority Health SBD |
$323.43
|
| Rate for Payer: Priority Health SBD |
$225.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
|
|
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION
|
Facility
|
OP
|
$5,160.33
|
|
|
Service Code
|
HCPCS J9264
|
| Hospital Charge Code |
40475
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$4,644.30 |
| Rate for Payer: Aetna Commercial |
$4,386.28
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,354.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.53
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$6.02
|
| Rate for Payer: BCBS Trust/PPO |
$20.14
|
| Rate for Payer: BCN Commercial |
$20.14
|
| Rate for Payer: BCN Medicare Advantage |
$6.02
|
| Rate for Payer: Cash Price |
$4,128.26
|
| Rate for Payer: Cash Price |
$4,128.26
|
| Rate for Payer: Cofinity Advantage |
$3,612.23
|
| Rate for Payer: Cofinity Commercial |
$4,437.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,128.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.02
|
| Rate for Payer: Healthscope Commercial |
$4,644.30
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Mclaren Medicare |
$6.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$6.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,386.28
|
| Rate for Payer: Nomi Health Commercial |
$18.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,870.25
|
| Rate for Payer: PACE Medicare |
$5.72
|
| Rate for Payer: PACE SWMI |
$6.02
|
| Rate for Payer: PHP Commercial |
$4,386.28
|
| Rate for Payer: PHP Medicare Advantage |
$6.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.24
|
| Rate for Payer: Priority Health Medicare |
$6.02
|
| Rate for Payer: Priority Health SBD |
$3,251.01
|
| Rate for Payer: Priority Health Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.50
|
| Rate for Payer: UHC Core |
$13.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.02
|
| Rate for Payer: UHC Exchange |
$13.50
|
| Rate for Payer: UHC Medicaid |
$3.15
|
| Rate for Payer: UHCCP Medicaid |
$3.15
|
| Rate for Payer: VA VA |
$6.02
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,136.76
|
|
|
Service Code
|
NDC 10147095103
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$716.16 |
| Max. Negotiated Rate |
$1,023.08 |
| Rate for Payer: Aetna Commercial |
$966.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.89
|
| Rate for Payer: Cash Price |
$909.41
|
| Rate for Payer: Cofinity Advantage |
$795.73
|
| Rate for Payer: Cofinity Commercial |
$977.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$909.41
|
| Rate for Payer: Healthscope Commercial |
$1,023.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.57
|
| Rate for Payer: PHP Commercial |
$966.25
|
| Rate for Payer: Priority Health SBD |
$716.16
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$223.67
|
|
|
Service Code
|
NDC 43975034903
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.90 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna Medicare |
$111.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: BCBS Complete |
$89.47
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.39
|
| Rate for Payer: UHC Core |
$116.53
|
| Rate for Payer: UHC Exchange |
$87.90
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,265.18
|
|
|
Service Code
|
NDC 50458055401
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$497.22 |
| Max. Negotiated Rate |
$1,138.66 |
| Rate for Payer: Aetna Commercial |
$1,075.40
|
| Rate for Payer: Aetna Medicare |
$632.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.37
|
| Rate for Payer: BCBS Complete |
$506.07
|
| Rate for Payer: Cash Price |
$1,012.14
|
| Rate for Payer: Cofinity Advantage |
$885.63
|
| Rate for Payer: Cofinity Commercial |
$1,088.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.14
|
| Rate for Payer: Healthscope Commercial |
$1,138.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,012.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.88
|
| Rate for Payer: PHP Commercial |
$1,075.40
|
| Rate for Payer: Priority Health SBD |
$797.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.37
|
| Rate for Payer: UHC Core |
$659.16
|
| Rate for Payer: UHC Exchange |
$497.22
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,265.18
|
|
|
Service Code
|
NDC 50458055401
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$797.06 |
| Max. Negotiated Rate |
$1,138.66 |
| Rate for Payer: Aetna Commercial |
$1,075.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.37
|
| Rate for Payer: Cash Price |
$1,012.14
|
| Rate for Payer: Cofinity Advantage |
$885.63
|
| Rate for Payer: Cofinity Commercial |
$1,088.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.14
|
| Rate for Payer: Healthscope Commercial |
$1,138.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.88
|
| Rate for Payer: PHP Commercial |
$1,075.40
|
| Rate for Payer: Priority Health SBD |
$797.06
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,136.76
|
|
|
Service Code
|
NDC 10147095103
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$446.75 |
| Max. Negotiated Rate |
$1,023.08 |
| Rate for Payer: Aetna Commercial |
$966.25
|
| Rate for Payer: Aetna Medicare |
$568.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.89
|
| Rate for Payer: BCBS Complete |
$454.70
|
| Rate for Payer: Cash Price |
$909.41
|
| Rate for Payer: Cofinity Advantage |
$795.73
|
| Rate for Payer: Cofinity Commercial |
$977.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$909.41
|
| Rate for Payer: Healthscope Commercial |
$1,023.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$909.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.57
|
| Rate for Payer: PHP Commercial |
$966.25
|
| Rate for Payer: Priority Health SBD |
$716.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.89
|
| Rate for Payer: UHC Core |
$592.25
|
| Rate for Payer: UHC Exchange |
$446.75
|
|
|
PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$223.67
|
|
|
Service Code
|
NDC 43975034903
|
| Hospital Charge Code |
100011
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.91 |
| Max. Negotiated Rate |
$201.30 |
| Rate for Payer: Aetna Commercial |
$190.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.39
|
| Rate for Payer: Cash Price |
$178.94
|
| Rate for Payer: Cofinity Advantage |
$156.57
|
| Rate for Payer: Cofinity Commercial |
$192.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.94
|
| Rate for Payer: Healthscope Commercial |
$201.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.75
|
| Rate for Payer: PHP Commercial |
$190.12
|
| Rate for Payer: Priority Health SBD |
$140.91
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,136.76
|
|
|
Service Code
|
NDC 10147095203
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$446.75 |
| Max. Negotiated Rate |
$1,023.08 |
| Rate for Payer: Aetna Commercial |
$966.25
|
| Rate for Payer: Aetna Medicare |
$568.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.89
|
| Rate for Payer: BCBS Complete |
$454.70
|
| Rate for Payer: Cash Price |
$909.41
|
| Rate for Payer: Cofinity Advantage |
$795.73
|
| Rate for Payer: Cofinity Commercial |
$977.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$909.41
|
| Rate for Payer: Healthscope Commercial |
$1,023.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$909.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.57
|
| Rate for Payer: PHP Commercial |
$966.25
|
| Rate for Payer: Priority Health SBD |
$716.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.89
|
| Rate for Payer: UHC Core |
$592.25
|
| Rate for Payer: UHC Exchange |
$446.75
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4,186.18
|
|
|
Service Code
|
NDC 00904693561
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,637.29 |
| Max. Negotiated Rate |
$3,767.56 |
| Rate for Payer: Aetna Commercial |
$3,558.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,721.02
|
| Rate for Payer: Cash Price |
$3,348.94
|
| Rate for Payer: Cofinity Advantage |
$2,930.33
|
| Rate for Payer: Cofinity Commercial |
$3,600.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,348.94
|
| Rate for Payer: Healthscope Commercial |
$3,767.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,558.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,139.64
|
| Rate for Payer: PHP Commercial |
$3,558.25
|
| Rate for Payer: Priority Health SBD |
$2,637.29
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,290.49
|
|
|
Service Code
|
NDC 50458055001
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$813.01 |
| Max. Negotiated Rate |
$1,161.44 |
| Rate for Payer: Aetna Commercial |
$1,096.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.82
|
| Rate for Payer: Cash Price |
$1,032.39
|
| Rate for Payer: Cofinity Advantage |
$903.34
|
| Rate for Payer: Cofinity Commercial |
$1,109.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.39
|
| Rate for Payer: Healthscope Commercial |
$1,161.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.87
|
| Rate for Payer: PHP Commercial |
$1,096.92
|
| Rate for Payer: Priority Health SBD |
$813.01
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$4,186.18
|
|
|
Service Code
|
NDC 00904693561
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,645.17 |
| Max. Negotiated Rate |
$3,767.56 |
| Rate for Payer: Aetna Commercial |
$3,558.25
|
| Rate for Payer: Aetna Medicare |
$2,093.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,721.02
|
| Rate for Payer: BCBS Complete |
$1,674.47
|
| Rate for Payer: Cash Price |
$3,348.94
|
| Rate for Payer: Cofinity Advantage |
$2,930.33
|
| Rate for Payer: Cofinity Commercial |
$3,600.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,348.94
|
| Rate for Payer: Healthscope Commercial |
$3,767.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,348.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,558.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,139.64
|
| Rate for Payer: PHP Commercial |
$3,558.25
|
| Rate for Payer: Priority Health SBD |
$2,637.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,721.02
|
| Rate for Payer: UHC Core |
$2,181.00
|
| Rate for Payer: UHC Exchange |
$1,645.17
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$1,290.49
|
|
|
Service Code
|
NDC 50458055001
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$507.16 |
| Max. Negotiated Rate |
$1,161.44 |
| Rate for Payer: Aetna Commercial |
$1,096.92
|
| Rate for Payer: Aetna Medicare |
$645.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.82
|
| Rate for Payer: BCBS Complete |
$516.20
|
| Rate for Payer: Cash Price |
$1,032.39
|
| Rate for Payer: Cofinity Advantage |
$903.34
|
| Rate for Payer: Cofinity Commercial |
$1,109.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.39
|
| Rate for Payer: Healthscope Commercial |
$1,161.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,032.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.87
|
| Rate for Payer: PHP Commercial |
$1,096.92
|
| Rate for Payer: Priority Health SBD |
$813.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.82
|
| Rate for Payer: UHC Core |
$672.35
|
| Rate for Payer: UHC Exchange |
$507.16
|
|
|
PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,136.76
|
|
|
Service Code
|
NDC 10147095203
|
| Hospital Charge Code |
78064
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$716.16 |
| Max. Negotiated Rate |
$1,023.08 |
| Rate for Payer: Aetna Commercial |
$966.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.89
|
| Rate for Payer: Cash Price |
$909.41
|
| Rate for Payer: Cofinity Advantage |
$795.73
|
| Rate for Payer: Cofinity Commercial |
$977.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$909.41
|
| Rate for Payer: Healthscope Commercial |
$1,023.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.57
|
| Rate for Payer: PHP Commercial |
$966.25
|
| Rate for Payer: Priority Health SBD |
$716.16
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$104.31
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
36591
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.72 |
| Max. Negotiated Rate |
$93.88 |
| Rate for Payer: Aetna Commercial |
$88.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.80
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cofinity Advantage |
$73.02
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.45
|
| Rate for Payer: Healthscope Commercial |
$93.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.23
|
| Rate for Payer: PHP Commercial |
$88.66
|
| Rate for Payer: Priority Health SBD |
$65.72
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$107.24
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
36591
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$96.52 |
| Rate for Payer: Aetna Commercial |
$91.15
|
| Rate for Payer: Aetna Commercial |
$153.17
|
| Rate for Payer: Aetna Commercial |
$88.66
|
| Rate for Payer: Aetna Medicare |
$90.10
|
| Rate for Payer: Aetna Medicare |
$53.62
|
| Rate for Payer: Aetna Medicare |
$52.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.80
|
| Rate for Payer: BCBS Complete |
$72.08
|
| Rate for Payer: BCBS Complete |
$41.72
|
| Rate for Payer: BCBS Complete |
$42.90
|
| Rate for Payer: BCBS Trust/PPO |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.86
|
| Rate for Payer: BCN Commercial |
$0.86
|
| Rate for Payer: BCN Commercial |
$0.86
|
| Rate for Payer: BCN Commercial |
$0.86
|
| Rate for Payer: Cash Price |
$85.79
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cash Price |
$144.16
|
| Rate for Payer: Cash Price |
$85.79
|
| Rate for Payer: Cash Price |
$144.16
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cofinity Advantage |
$75.07
|
| Rate for Payer: Cofinity Advantage |
$73.02
|
| Rate for Payer: Cofinity Advantage |
$126.14
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$92.23
|
| Rate for Payer: Cofinity Commercial |
$154.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.16
|
| Rate for Payer: Healthscope Commercial |
$162.18
|
| Rate for Payer: Healthscope Commercial |
$96.52
|
| Rate for Payer: Healthscope Commercial |
$93.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.43
|
| Rate for Payer: PHP Commercial |
$91.15
|
| Rate for Payer: PHP Commercial |
$153.17
|
| Rate for Payer: PHP Commercial |
$88.66
|
| Rate for Payer: Priority Health SBD |
$113.53
|
| Rate for Payer: Priority Health SBD |
$67.56
|
| Rate for Payer: Priority Health SBD |
$65.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$129.64
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
188040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$81.67 |
| Max. Negotiated Rate |
$116.68 |
| Rate for Payer: Aetna Commercial |
$110.19
|
| Rate for Payer: Aetna Commercial |
$224.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.32
|
| Rate for Payer: Cash Price |
$103.71
|
| Rate for Payer: Cash Price |
$210.86
|
| Rate for Payer: Cofinity Advantage |
$90.75
|
| Rate for Payer: Cofinity Advantage |
$184.50
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Cofinity Commercial |
$226.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$116.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.68
|
| Rate for Payer: PHP Commercial |
$110.19
|
| Rate for Payer: PHP Commercial |
$224.03
|
| Rate for Payer: Priority Health SBD |
$81.67
|
| Rate for Payer: Priority Health SBD |
$166.05
|
|
