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Service Code NDC 60687072511
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $0.87
Max. Negotiated Rate $1.96
Rate for Payer: Aetna Commercial $1.85
Rate for Payer: Aetna Medicare $1.09
Rate for Payer: Aetna New Business (MI Preferred) $1.42
Rate for Payer: BCBS Complete $0.87
Rate for Payer: Cash Price $1.74
Rate for Payer: Cofinity Commercial $1.53
Rate for Payer: Cofinity Commercial $1.87
Rate for Payer: Cofinity Medicare Advantage $1.53
Rate for Payer: Encore Health Key Benefits Commercial $1.74
Rate for Payer: Healthscope Commercial $1.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial $1.85
Rate for Payer: PHP Commercial $1.85
Rate for Payer: Priority Health Cigna Priority Health $1.42
Rate for Payer: Priority Health SBD $1.37
Service Code NDC 68084064301
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $86.26
Max. Negotiated Rate $194.08
Rate for Payer: Aetna Commercial $183.30
Rate for Payer: Aetna Medicare $107.82
Rate for Payer: Aetna New Business (MI Preferred) $140.17
Rate for Payer: BCBS Complete $86.26
Rate for Payer: Cash Price $172.52
Rate for Payer: Cofinity Commercial $150.96
Rate for Payer: Cofinity Commercial $185.46
Rate for Payer: Cofinity Medicare Advantage $150.96
Rate for Payer: Encore Health Key Benefits Commercial $172.52
Rate for Payer: Healthscope Commercial $194.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial $183.30
Rate for Payer: PHP Commercial $183.30
Rate for Payer: Priority Health Cigna Priority Health $140.17
Rate for Payer: Priority Health SBD $135.86
Service Code NDC 60687072501
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $137.06
Max. Negotiated Rate $195.80
Rate for Payer: Aetna Commercial $184.92
Rate for Payer: Aetna New Business (MI Preferred) $141.41
Rate for Payer: Cash Price $174.04
Rate for Payer: Cofinity Commercial $152.28
Rate for Payer: Cofinity Commercial $187.09
Rate for Payer: Cofinity Medicare Advantage $152.28
Rate for Payer: Encore Health Key Benefits Commercial $174.04
Rate for Payer: Healthscope Commercial $195.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial $184.92
Rate for Payer: PHP Commercial $184.92
Rate for Payer: Priority Health Cigna Priority Health $141.41
Rate for Payer: Priority Health SBD $137.06
Service Code NDC 60687072501
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $87.02
Max. Negotiated Rate $195.80
Rate for Payer: Aetna Commercial $184.92
Rate for Payer: Aetna Medicare $108.78
Rate for Payer: Aetna New Business (MI Preferred) $141.41
Rate for Payer: BCBS Complete $87.02
Rate for Payer: Cash Price $174.04
Rate for Payer: Cofinity Commercial $152.28
Rate for Payer: Cofinity Commercial $187.09
Rate for Payer: Cofinity Medicare Advantage $152.28
Rate for Payer: Encore Health Key Benefits Commercial $174.04
Rate for Payer: Healthscope Commercial $195.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial $184.92
Rate for Payer: PHP Commercial $184.92
Rate for Payer: Priority Health Cigna Priority Health $141.41
Rate for Payer: Priority Health SBD $137.06
Service Code NDC 68084064311
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $1.36
Max. Negotiated Rate $1.94
Rate for Payer: Aetna Commercial $1.84
Rate for Payer: Aetna New Business (MI Preferred) $1.40
Rate for Payer: Cash Price $1.73
Rate for Payer: Cofinity Commercial $1.51
Rate for Payer: Cofinity Commercial $1.86
Rate for Payer: Cofinity Medicare Advantage $1.51
Rate for Payer: Encore Health Key Benefits Commercial $1.73
Rate for Payer: Healthscope Commercial $1.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial $1.84
Rate for Payer: PHP Commercial $1.84
Rate for Payer: Priority Health Cigna Priority Health $1.40
Rate for Payer: Priority Health SBD $1.36
Service Code NDC 60687058501
Hospital Charge Code 26224
Hospital Revenue Code 637
Min. Negotiated Rate $124.49
Max. Negotiated Rate $177.84
Rate for Payer: Aetna Commercial $167.96
Rate for Payer: Aetna New Business (MI Preferred) $128.44
Rate for Payer: Cash Price $158.08
Rate for Payer: Cofinity Commercial $138.32
Rate for Payer: Cofinity Commercial $169.94
Rate for Payer: Cofinity Medicare Advantage $138.32
Rate for Payer: Encore Health Key Benefits Commercial $158.08
Rate for Payer: Healthscope Commercial $177.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial $167.96
Rate for Payer: PHP Commercial $167.96
Rate for Payer: Priority Health Cigna Priority Health $128.44
Rate for Payer: Priority Health SBD $124.49
Service Code HCPCS J2470
Hospital Charge Code 26226
Hospital Revenue Code 636
Min. Negotiated Rate $8.40
Max. Negotiated Rate $18.90
Rate for Payer: Aetna Commercial $17.85
Rate for Payer: Aetna Commercial $17.60
Rate for Payer: Aetna Commercial $22.40
Rate for Payer: Aetna Commercial $14.35
Rate for Payer: Aetna Commercial $14.06
Rate for Payer: Aetna Commercial $19.10
Rate for Payer: Aetna Commercial $18.18
Rate for Payer: Aetna Medicare $10.70
Rate for Payer: Aetna Medicare $10.35
Rate for Payer: Aetna Medicare $8.27
Rate for Payer: Aetna Medicare $10.50
Rate for Payer: Aetna Medicare $8.44
Rate for Payer: Aetna Medicare $13.18
Rate for Payer: Aetna Medicare $11.24
Rate for Payer: Aetna New Business (MI Preferred) $13.65
Rate for Payer: Aetna New Business (MI Preferred) $13.90
Rate for Payer: Aetna New Business (MI Preferred) $10.97
Rate for Payer: Aetna New Business (MI Preferred) $10.75
Rate for Payer: Aetna New Business (MI Preferred) $13.46
Rate for Payer: Aetna New Business (MI Preferred) $14.61
Rate for Payer: Aetna New Business (MI Preferred) $17.13
Rate for Payer: BCBS Complete $6.75
Rate for Payer: BCBS Complete $6.62
Rate for Payer: BCBS Complete $8.56
Rate for Payer: BCBS Complete $8.99
Rate for Payer: BCBS Complete $10.54
Rate for Payer: BCBS Complete $8.28
Rate for Payer: BCBS Complete $8.40
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: Cash Price $21.08
Rate for Payer: Cash Price $13.50
Rate for Payer: Cash Price $13.23
Rate for Payer: Cash Price $16.56
Rate for Payer: Cash Price $13.50
Rate for Payer: Cash Price $16.56
Rate for Payer: Cash Price $16.80
Rate for Payer: Cash Price $16.80
Rate for Payer: Cash Price $13.23
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $21.08
Rate for Payer: Cofinity Commercial $18.06
Rate for Payer: Cofinity Commercial $11.58
Rate for Payer: Cofinity Commercial $14.22
Rate for Payer: Cofinity Commercial $11.82
Rate for Payer: Cofinity Commercial $14.52
Rate for Payer: Cofinity Commercial $14.49
Rate for Payer: Cofinity Commercial $17.80
Rate for Payer: Cofinity Commercial $14.70
Rate for Payer: Cofinity Commercial $22.66
Rate for Payer: Cofinity Commercial $18.44
Rate for Payer: Cofinity Commercial $14.97
Rate for Payer: Cofinity Commercial $18.40
Rate for Payer: Cofinity Commercial $19.32
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Medicare Advantage $14.97
Rate for Payer: Cofinity Medicare Advantage $11.82
Rate for Payer: Cofinity Medicare Advantage $14.70
Rate for Payer: Cofinity Medicare Advantage $11.58
Rate for Payer: Cofinity Medicare Advantage $15.73
Rate for Payer: Cofinity Medicare Advantage $14.49
Rate for Payer: Cofinity Medicare Advantage $18.44
Rate for Payer: Encore Health Key Benefits Commercial $16.56
Rate for Payer: Encore Health Key Benefits Commercial $13.23
Rate for Payer: Encore Health Key Benefits Commercial $16.80
Rate for Payer: Encore Health Key Benefits Commercial $17.98
Rate for Payer: Encore Health Key Benefits Commercial $21.08
Rate for Payer: Encore Health Key Benefits Commercial $17.11
Rate for Payer: Encore Health Key Benefits Commercial $13.50
Rate for Payer: Healthscope Commercial $19.25
Rate for Payer: Healthscope Commercial $18.63
Rate for Payer: Healthscope Commercial $18.90
Rate for Payer: Healthscope Commercial $23.72
Rate for Payer: Healthscope Commercial $15.19
Rate for Payer: Healthscope Commercial $20.22
Rate for Payer: Healthscope Commercial $14.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial $19.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.60
Rate for Payer: PHP Commercial $17.85
Rate for Payer: PHP Commercial $14.35
Rate for Payer: PHP Commercial $19.10
Rate for Payer: PHP Commercial $22.40
Rate for Payer: PHP Commercial $18.18
Rate for Payer: PHP Commercial $17.60
Rate for Payer: PHP Commercial $14.06
Rate for Payer: Priority Health Cigna Priority Health $13.46
Rate for Payer: Priority Health Cigna Priority Health $13.90
Rate for Payer: Priority Health Cigna Priority Health $14.61
Rate for Payer: Priority Health Cigna Priority Health $17.13
Rate for Payer: Priority Health Cigna Priority Health $13.65
Rate for Payer: Priority Health Cigna Priority Health $10.97
Rate for Payer: Priority Health Cigna Priority Health $10.75
Rate for Payer: Priority Health SBD $13.48
Rate for Payer: Priority Health SBD $14.16
Rate for Payer: Priority Health SBD $13.23
Rate for Payer: Priority Health SBD $13.04
Rate for Payer: Priority Health SBD $10.42
Rate for Payer: Priority Health SBD $10.63
Rate for Payer: Priority Health SBD $16.60
Service Code HCPCS J2471
Hospital Charge Code 26226
Hospital Revenue Code 636
Min. Negotiated Rate $7.71
Max. Negotiated Rate $17.34
Rate for Payer: Aetna Commercial $16.38
Rate for Payer: Aetna Commercial $22.41
Rate for Payer: Aetna Medicare $13.18
Rate for Payer: Aetna Medicare $9.64
Rate for Payer: Aetna New Business (MI Preferred) $12.53
Rate for Payer: Aetna New Business (MI Preferred) $17.14
Rate for Payer: BCBS Complete $10.55
Rate for Payer: BCBS Complete $7.71
Rate for Payer: BCBS Trust/PPO $13.14
Rate for Payer: BCBS Trust/PPO $13.14
Rate for Payer: BCN Commercial $13.14
Rate for Payer: BCN Commercial $13.14
Rate for Payer: Cash Price $21.10
Rate for Payer: Cash Price $21.10
Rate for Payer: Cash Price $15.42
Rate for Payer: Cash Price $15.42
Rate for Payer: Cofinity Commercial $13.49
Rate for Payer: Cofinity Commercial $22.68
Rate for Payer: Cofinity Commercial $18.46
Rate for Payer: Cofinity Commercial $16.57
Rate for Payer: Cofinity Medicare Advantage $18.46
Rate for Payer: Cofinity Medicare Advantage $13.49
Rate for Payer: Encore Health Key Benefits Commercial $15.42
Rate for Payer: Encore Health Key Benefits Commercial $21.10
Rate for Payer: Healthscope Commercial $17.34
Rate for Payer: Healthscope Commercial $23.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial $16.38
Rate for Payer: PHP Commercial $22.41
Rate for Payer: PHP Commercial $16.38
Rate for Payer: Priority Health Cigna Priority Health $12.53
Rate for Payer: Priority Health Cigna Priority Health $17.14
Rate for Payer: Priority Health SBD $16.61
Rate for Payer: Priority Health SBD $12.14
Service Code HCPCS J2471
Hospital Charge Code 26226
Hospital Revenue Code 636
Min. Negotiated Rate $12.14
Max. Negotiated Rate $17.34
Rate for Payer: Aetna Commercial $16.38
Rate for Payer: Aetna Commercial $22.41
Rate for Payer: Aetna New Business (MI Preferred) $12.53
Rate for Payer: Aetna New Business (MI Preferred) $17.14
Rate for Payer: Cash Price $15.42
Rate for Payer: Cash Price $21.10
Rate for Payer: Cofinity Commercial $13.49
Rate for Payer: Cofinity Commercial $18.46
Rate for Payer: Cofinity Commercial $22.68
Rate for Payer: Cofinity Commercial $16.57
Rate for Payer: Cofinity Medicare Advantage $18.46
Rate for Payer: Cofinity Medicare Advantage $13.49
Rate for Payer: Encore Health Key Benefits Commercial $15.42
Rate for Payer: Encore Health Key Benefits Commercial $21.10
Rate for Payer: Healthscope Commercial $17.34
Rate for Payer: Healthscope Commercial $23.73
Rate for Payer: Multiplan/Beech St/PHCS Commercial $16.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.41
Rate for Payer: PHP Commercial $16.38
Rate for Payer: PHP Commercial $22.41
Rate for Payer: Priority Health Cigna Priority Health $17.14
Rate for Payer: Priority Health Cigna Priority Health $12.53
Rate for Payer: Priority Health SBD $16.61
Rate for Payer: Priority Health SBD $12.14
Service Code HCPCS J2470
Hospital Charge Code 26226
Hospital Revenue Code 636
Min. Negotiated Rate $14.16
Max. Negotiated Rate $20.22
Rate for Payer: Aetna Commercial $19.10
Rate for Payer: Aetna Commercial $14.35
Rate for Payer: Aetna Commercial $17.85
Rate for Payer: Aetna Commercial $18.18
Rate for Payer: Aetna Commercial $14.06
Rate for Payer: Aetna Commercial $17.60
Rate for Payer: Aetna Commercial $22.40
Rate for Payer: Aetna New Business (MI Preferred) $13.65
Rate for Payer: Aetna New Business (MI Preferred) $17.13
Rate for Payer: Aetna New Business (MI Preferred) $13.46
Rate for Payer: Aetna New Business (MI Preferred) $10.97
Rate for Payer: Aetna New Business (MI Preferred) $14.61
Rate for Payer: Aetna New Business (MI Preferred) $10.75
Rate for Payer: Aetna New Business (MI Preferred) $13.90
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $16.80
Rate for Payer: Cash Price $13.50
Rate for Payer: Cash Price $13.23
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $21.08
Rate for Payer: Cash Price $16.56
Rate for Payer: Cofinity Commercial $18.44
Rate for Payer: Cofinity Commercial $19.32
Rate for Payer: Cofinity Commercial $11.58
Rate for Payer: Cofinity Commercial $14.22
Rate for Payer: Cofinity Commercial $11.82
Rate for Payer: Cofinity Commercial $14.52
Rate for Payer: Cofinity Commercial $14.49
Rate for Payer: Cofinity Commercial $17.80
Rate for Payer: Cofinity Commercial $14.70
Rate for Payer: Cofinity Commercial $18.06
Rate for Payer: Cofinity Commercial $14.97
Rate for Payer: Cofinity Commercial $18.40
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Commercial $22.66
Rate for Payer: Cofinity Medicare Advantage $14.70
Rate for Payer: Cofinity Medicare Advantage $11.58
Rate for Payer: Cofinity Medicare Advantage $14.97
Rate for Payer: Cofinity Medicare Advantage $14.49
Rate for Payer: Cofinity Medicare Advantage $11.82
Rate for Payer: Cofinity Medicare Advantage $15.73
Rate for Payer: Cofinity Medicare Advantage $18.44
Rate for Payer: Encore Health Key Benefits Commercial $21.08
Rate for Payer: Encore Health Key Benefits Commercial $13.50
Rate for Payer: Encore Health Key Benefits Commercial $16.80
Rate for Payer: Encore Health Key Benefits Commercial $13.23
Rate for Payer: Encore Health Key Benefits Commercial $17.11
Rate for Payer: Encore Health Key Benefits Commercial $16.56
Rate for Payer: Encore Health Key Benefits Commercial $17.98
Rate for Payer: Healthscope Commercial $15.19
Rate for Payer: Healthscope Commercial $19.25
Rate for Payer: Healthscope Commercial $18.63
Rate for Payer: Healthscope Commercial $18.90
Rate for Payer: Healthscope Commercial $14.89
Rate for Payer: Healthscope Commercial $20.22
Rate for Payer: Healthscope Commercial $23.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.06
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial $19.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.40
Rate for Payer: PHP Commercial $19.10
Rate for Payer: PHP Commercial $17.60
Rate for Payer: PHP Commercial $14.06
Rate for Payer: PHP Commercial $18.18
Rate for Payer: PHP Commercial $17.85
Rate for Payer: PHP Commercial $14.35
Rate for Payer: PHP Commercial $22.40
Rate for Payer: Priority Health Cigna Priority Health $13.65
Rate for Payer: Priority Health Cigna Priority Health $10.75
Rate for Payer: Priority Health Cigna Priority Health $13.90
Rate for Payer: Priority Health Cigna Priority Health $13.46
Rate for Payer: Priority Health Cigna Priority Health $17.13
Rate for Payer: Priority Health Cigna Priority Health $14.61
Rate for Payer: Priority Health Cigna Priority Health $10.97
Rate for Payer: Priority Health SBD $13.48
Rate for Payer: Priority Health SBD $10.63
Rate for Payer: Priority Health SBD $16.60
Rate for Payer: Priority Health SBD $10.42
Rate for Payer: Priority Health SBD $13.04
Rate for Payer: Priority Health SBD $13.23
Rate for Payer: Priority Health SBD $14.16
Service Code HCPCS J2470
Hospital Charge Code 301183
Hospital Revenue Code 636
Min. Negotiated Rate $14.16
Max. Negotiated Rate $20.22
Rate for Payer: Aetna Commercial $19.10
Rate for Payer: Aetna Commercial $18.18
Rate for Payer: Aetna Commercial $22.40
Rate for Payer: Aetna Commercial $17.60
Rate for Payer: Aetna New Business (MI Preferred) $13.90
Rate for Payer: Aetna New Business (MI Preferred) $13.46
Rate for Payer: Aetna New Business (MI Preferred) $14.61
Rate for Payer: Aetna New Business (MI Preferred) $17.13
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $16.56
Rate for Payer: Cash Price $21.08
Rate for Payer: Cofinity Commercial $14.49
Rate for Payer: Cofinity Commercial $22.66
Rate for Payer: Cofinity Commercial $18.44
Rate for Payer: Cofinity Commercial $14.97
Rate for Payer: Cofinity Commercial $18.40
Rate for Payer: Cofinity Commercial $19.32
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Commercial $17.80
Rate for Payer: Cofinity Medicare Advantage $14.49
Rate for Payer: Cofinity Medicare Advantage $14.97
Rate for Payer: Cofinity Medicare Advantage $15.73
Rate for Payer: Cofinity Medicare Advantage $18.44
Rate for Payer: Encore Health Key Benefits Commercial $17.98
Rate for Payer: Encore Health Key Benefits Commercial $16.56
Rate for Payer: Encore Health Key Benefits Commercial $17.11
Rate for Payer: Encore Health Key Benefits Commercial $21.08
Rate for Payer: Healthscope Commercial $19.25
Rate for Payer: Healthscope Commercial $18.63
Rate for Payer: Healthscope Commercial $23.72
Rate for Payer: Healthscope Commercial $20.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial $19.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.60
Rate for Payer: PHP Commercial $17.60
Rate for Payer: PHP Commercial $19.10
Rate for Payer: PHP Commercial $18.18
Rate for Payer: PHP Commercial $22.40
Rate for Payer: Priority Health Cigna Priority Health $13.90
Rate for Payer: Priority Health Cigna Priority Health $14.61
Rate for Payer: Priority Health Cigna Priority Health $13.46
Rate for Payer: Priority Health Cigna Priority Health $17.13
Rate for Payer: Priority Health SBD $13.04
Rate for Payer: Priority Health SBD $14.16
Rate for Payer: Priority Health SBD $13.48
Rate for Payer: Priority Health SBD $16.60
Service Code HCPCS J2470
Hospital Charge Code 301183
Hospital Revenue Code 636
Min. Negotiated Rate $10.54
Max. Negotiated Rate $23.72
Rate for Payer: Aetna Commercial $22.40
Rate for Payer: Aetna Commercial $17.60
Rate for Payer: Aetna Commercial $19.10
Rate for Payer: Aetna Commercial $18.18
Rate for Payer: Aetna Medicare $11.24
Rate for Payer: Aetna Medicare $10.35
Rate for Payer: Aetna Medicare $13.18
Rate for Payer: Aetna Medicare $10.70
Rate for Payer: Aetna New Business (MI Preferred) $17.13
Rate for Payer: Aetna New Business (MI Preferred) $14.61
Rate for Payer: Aetna New Business (MI Preferred) $13.46
Rate for Payer: Aetna New Business (MI Preferred) $13.90
Rate for Payer: BCBS Complete $8.99
Rate for Payer: BCBS Complete $10.54
Rate for Payer: BCBS Complete $8.56
Rate for Payer: BCBS Complete $8.28
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCBS Trust/PPO $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: BCN Commercial $14.39
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $16.56
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $17.11
Rate for Payer: Cash Price $17.98
Rate for Payer: Cash Price $21.08
Rate for Payer: Cash Price $21.08
Rate for Payer: Cash Price $16.56
Rate for Payer: Cofinity Commercial $14.97
Rate for Payer: Cofinity Commercial $14.49
Rate for Payer: Cofinity Commercial $17.80
Rate for Payer: Cofinity Commercial $18.40
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Commercial $19.32
Rate for Payer: Cofinity Commercial $18.44
Rate for Payer: Cofinity Commercial $22.66
Rate for Payer: Cofinity Medicare Advantage $18.44
Rate for Payer: Cofinity Medicare Advantage $14.49
Rate for Payer: Cofinity Medicare Advantage $15.73
Rate for Payer: Cofinity Medicare Advantage $14.97
Rate for Payer: Encore Health Key Benefits Commercial $16.56
Rate for Payer: Encore Health Key Benefits Commercial $21.08
Rate for Payer: Encore Health Key Benefits Commercial $17.98
Rate for Payer: Encore Health Key Benefits Commercial $17.11
Rate for Payer: Healthscope Commercial $19.25
Rate for Payer: Healthscope Commercial $23.72
Rate for Payer: Healthscope Commercial $20.22
Rate for Payer: Healthscope Commercial $18.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial $17.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial $19.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial $22.40
Rate for Payer: PHP Commercial $22.40
Rate for Payer: PHP Commercial $18.18
Rate for Payer: PHP Commercial $19.10
Rate for Payer: PHP Commercial $17.60
Rate for Payer: Priority Health Cigna Priority Health $13.46
Rate for Payer: Priority Health Cigna Priority Health $17.13
Rate for Payer: Priority Health Cigna Priority Health $14.61
Rate for Payer: Priority Health Cigna Priority Health $13.90
Rate for Payer: Priority Health SBD $16.60
Rate for Payer: Priority Health SBD $13.48
Rate for Payer: Priority Health SBD $13.04
Rate for Payer: Priority Health SBD $14.16
Service Code NDC 68084081309
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $127.84
Max. Negotiated Rate $287.64
Rate for Payer: Aetna Commercial $271.66
Rate for Payer: Aetna Medicare $159.80
Rate for Payer: Aetna New Business (MI Preferred) $207.74
Rate for Payer: BCBS Complete $127.84
Rate for Payer: Cash Price $255.68
Rate for Payer: Cofinity Commercial $223.72
Rate for Payer: Cofinity Commercial $274.86
Rate for Payer: Cofinity Medicare Advantage $223.72
Rate for Payer: Encore Health Key Benefits Commercial $255.68
Rate for Payer: Healthscope Commercial $287.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial $271.66
Rate for Payer: PHP Commercial $271.66
Rate for Payer: Priority Health Cigna Priority Health $207.74
Rate for Payer: Priority Health SBD $201.35
Service Code NDC 51079005101
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $0.89
Max. Negotiated Rate $2.00
Rate for Payer: Aetna Commercial $1.89
Rate for Payer: Aetna Medicare $1.11
Rate for Payer: Aetna New Business (MI Preferred) $1.44
Rate for Payer: BCBS Complete $0.89
Rate for Payer: Cash Price $1.78
Rate for Payer: Cofinity Commercial $1.55
Rate for Payer: Cofinity Commercial $1.91
Rate for Payer: Cofinity Medicare Advantage $1.55
Rate for Payer: Encore Health Key Benefits Commercial $1.78
Rate for Payer: Healthscope Commercial $2.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial $1.89
Rate for Payer: PHP Commercial $1.89
Rate for Payer: Priority Health Cigna Priority Health $1.44
Rate for Payer: Priority Health SBD $1.40
Service Code NDC 35573042880
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $88.16
Max. Negotiated Rate $198.36
Rate for Payer: Aetna Commercial $187.34
Rate for Payer: Aetna Medicare $110.20
Rate for Payer: Aetna New Business (MI Preferred) $143.26
Rate for Payer: BCBS Complete $88.16
Rate for Payer: Cash Price $176.32
Rate for Payer: Cofinity Commercial $154.28
Rate for Payer: Cofinity Commercial $189.54
Rate for Payer: Cofinity Medicare Advantage $154.28
Rate for Payer: Encore Health Key Benefits Commercial $176.32
Rate for Payer: Healthscope Commercial $198.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial $187.34
Rate for Payer: PHP Commercial $187.34
Rate for Payer: Priority Health Cigna Priority Health $143.26
Rate for Payer: Priority Health SBD $138.85
Service Code NDC 68084081309
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $201.35
Max. Negotiated Rate $287.64
Rate for Payer: Aetna Commercial $271.66
Rate for Payer: Aetna New Business (MI Preferred) $207.74
Rate for Payer: Cash Price $255.68
Rate for Payer: Cofinity Commercial $223.72
Rate for Payer: Cofinity Commercial $274.86
Rate for Payer: Cofinity Medicare Advantage $223.72
Rate for Payer: Encore Health Key Benefits Commercial $255.68
Rate for Payer: Healthscope Commercial $287.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial $271.66
Rate for Payer: PHP Commercial $271.66
Rate for Payer: Priority Health Cigna Priority Health $207.74
Rate for Payer: Priority Health SBD $201.35
Service Code NDC 35573042880
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $138.85
Max. Negotiated Rate $198.36
Rate for Payer: Aetna Commercial $187.34
Rate for Payer: Aetna New Business (MI Preferred) $143.26
Rate for Payer: Cash Price $176.32
Rate for Payer: Cofinity Commercial $154.28
Rate for Payer: Cofinity Commercial $189.54
Rate for Payer: Cofinity Medicare Advantage $154.28
Rate for Payer: Encore Health Key Benefits Commercial $176.32
Rate for Payer: Healthscope Commercial $198.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial $187.34
Rate for Payer: PHP Commercial $187.34
Rate for Payer: Priority Health Cigna Priority Health $143.26
Rate for Payer: Priority Health SBD $138.85
Service Code NDC 68084081311
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $2.52
Max. Negotiated Rate $3.60
Rate for Payer: Aetna Commercial $3.40
Rate for Payer: Aetna New Business (MI Preferred) $2.60
Rate for Payer: Cash Price $3.20
Rate for Payer: Cofinity Commercial $2.80
Rate for Payer: Cofinity Commercial $3.44
Rate for Payer: Cofinity Medicare Advantage $2.80
Rate for Payer: Encore Health Key Benefits Commercial $3.20
Rate for Payer: Healthscope Commercial $3.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial $3.40
Rate for Payer: PHP Commercial $3.40
Rate for Payer: Priority Health Cigna Priority Health $2.60
Rate for Payer: Priority Health SBD $2.52
Service Code NDC 65862056099
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $432.40
Max. Negotiated Rate $972.90
Rate for Payer: Aetna Commercial $918.85
Rate for Payer: Aetna Medicare $540.50
Rate for Payer: Aetna New Business (MI Preferred) $702.65
Rate for Payer: BCBS Complete $432.40
Rate for Payer: Cash Price $864.80
Rate for Payer: Cofinity Commercial $756.70
Rate for Payer: Cofinity Commercial $929.66
Rate for Payer: Cofinity Medicare Advantage $756.70
Rate for Payer: Encore Health Key Benefits Commercial $864.80
Rate for Payer: Healthscope Commercial $972.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial $918.85
Rate for Payer: PHP Commercial $918.85
Rate for Payer: Priority Health Cigna Priority Health $702.65
Rate for Payer: Priority Health SBD $681.03
Service Code NDC 35573042851
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $1.39
Max. Negotiated Rate $1.99
Rate for Payer: Aetna Commercial $1.88
Rate for Payer: Aetna New Business (MI Preferred) $1.44
Rate for Payer: Cash Price $1.77
Rate for Payer: Cofinity Commercial $1.55
Rate for Payer: Cofinity Commercial $1.90
Rate for Payer: Cofinity Medicare Advantage $1.55
Rate for Payer: Encore Health Key Benefits Commercial $1.77
Rate for Payer: Healthscope Commercial $1.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial $1.88
Rate for Payer: PHP Commercial $1.88
Rate for Payer: Priority Health Cigna Priority Health $1.44
Rate for Payer: Priority Health SBD $1.39
Service Code NDC 60687073611
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $2.36
Max. Negotiated Rate $3.37
Rate for Payer: Aetna Commercial $3.18
Rate for Payer: Aetna New Business (MI Preferred) $2.43
Rate for Payer: Cash Price $2.99
Rate for Payer: Cofinity Commercial $2.62
Rate for Payer: Cofinity Commercial $3.22
Rate for Payer: Cofinity Medicare Advantage $2.62
Rate for Payer: Encore Health Key Benefits Commercial $2.99
Rate for Payer: Healthscope Commercial $3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial $3.18
Rate for Payer: PHP Commercial $3.18
Rate for Payer: Priority Health Cigna Priority Health $2.43
Rate for Payer: Priority Health SBD $2.36
Service Code NDC 60687073611
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $1.50
Max. Negotiated Rate $3.37
Rate for Payer: Aetna Commercial $3.18
Rate for Payer: Aetna Medicare $1.87
Rate for Payer: Aetna New Business (MI Preferred) $2.43
Rate for Payer: BCBS Complete $1.50
Rate for Payer: Cash Price $2.99
Rate for Payer: Cofinity Commercial $2.62
Rate for Payer: Cofinity Commercial $3.22
Rate for Payer: Cofinity Medicare Advantage $2.62
Rate for Payer: Encore Health Key Benefits Commercial $2.99
Rate for Payer: Healthscope Commercial $3.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial $3.18
Rate for Payer: PHP Commercial $3.18
Rate for Payer: Priority Health Cigna Priority Health $2.43
Rate for Payer: Priority Health SBD $2.36
Service Code NDC 60687073665
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $106.60
Max. Negotiated Rate $152.28
Rate for Payer: Aetna Commercial $143.82
Rate for Payer: Aetna New Business (MI Preferred) $109.98
Rate for Payer: Cash Price $135.36
Rate for Payer: Cofinity Commercial $118.44
Rate for Payer: Cofinity Commercial $145.51
Rate for Payer: Cofinity Medicare Advantage $118.44
Rate for Payer: Encore Health Key Benefits Commercial $135.36
Rate for Payer: Healthscope Commercial $152.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial $143.82
Rate for Payer: PHP Commercial $143.82
Rate for Payer: Priority Health Cigna Priority Health $109.98
Rate for Payer: Priority Health SBD $106.60
Service Code NDC 00008084181
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $2,824.20
Max. Negotiated Rate $4,034.56
Rate for Payer: Aetna Commercial $3,810.42
Rate for Payer: Aetna New Business (MI Preferred) $2,913.85
Rate for Payer: Cash Price $3,586.28
Rate for Payer: Cofinity Commercial $3,138.00
Rate for Payer: Cofinity Commercial $3,855.25
Rate for Payer: Cofinity Medicare Advantage $3,138.00
Rate for Payer: Encore Health Key Benefits Commercial $3,586.28
Rate for Payer: Healthscope Commercial $4,034.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial $3,810.42
Rate for Payer: PHP Commercial $3,810.42
Rate for Payer: Priority Health Cigna Priority Health $2,913.85
Rate for Payer: Priority Health SBD $2,824.20
Service Code NDC 55111033390
Hospital Charge Code 26225
Hospital Revenue Code 637
Min. Negotiated Rate $72.16
Max. Negotiated Rate $162.37
Rate for Payer: Aetna Commercial $153.35
Rate for Payer: Aetna Medicare $90.20
Rate for Payer: Aetna New Business (MI Preferred) $117.27
Rate for Payer: BCBS Complete $72.16
Rate for Payer: Cash Price $144.33
Rate for Payer: Cofinity Commercial $126.29
Rate for Payer: Cofinity Commercial $155.15
Rate for Payer: Cofinity Medicare Advantage $126.29
Rate for Payer: Encore Health Key Benefits Commercial $144.33
Rate for Payer: Healthscope Commercial $162.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial $153.35
Rate for Payer: PHP Commercial $153.35
Rate for Payer: Priority Health Cigna Priority Health $117.27
Rate for Payer: Priority Health SBD $113.66