|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION
|
Facility
|
OP
|
$423.71
|
|
|
Service Code
|
NDC 11980018005
|
| Hospital Charge Code |
6487
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.48 |
| Max. Negotiated Rate |
$381.34 |
| Rate for Payer: Aetna Commercial |
$360.15
|
| Rate for Payer: Aetna Medicare |
$211.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.41
|
| Rate for Payer: BCBS Complete |
$169.48
|
| Rate for Payer: Cash Price |
$338.97
|
| Rate for Payer: Cofinity Commercial |
$296.60
|
| Rate for Payer: Cofinity Commercial |
$364.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.97
|
| Rate for Payer: Healthscope Commercial |
$381.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.15
|
| Rate for Payer: PHP Commercial |
$360.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.41
|
| Rate for Payer: Priority Health SBD |
$266.94
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION
|
Facility
|
IP
|
$423.71
|
|
|
Service Code
|
NDC 11980018005
|
| Hospital Charge Code |
6487
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$266.94 |
| Max. Negotiated Rate |
$381.34 |
| Rate for Payer: Aetna Commercial |
$360.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.41
|
| Rate for Payer: Cash Price |
$338.97
|
| Rate for Payer: Cofinity Commercial |
$296.60
|
| Rate for Payer: Cofinity Commercial |
$364.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.97
|
| Rate for Payer: Healthscope Commercial |
$381.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.15
|
| Rate for Payer: PHP Commercial |
$360.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.41
|
| Rate for Payer: Priority Health SBD |
$266.94
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$807.58
|
|
|
Service Code
|
HCPCS J7510
|
| Hospital Charge Code |
29302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$508.78 |
| Max. Negotiated Rate |
$726.82 |
| Rate for Payer: Aetna Commercial |
$686.44
|
| Rate for Payer: Aetna Commercial |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.93
|
| Rate for Payer: Cash Price |
$6.39
|
| Rate for Payer: Cash Price |
$646.06
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Cofinity Commercial |
$565.31
|
| Rate for Payer: Cofinity Commercial |
$694.52
|
| Rate for Payer: Cofinity Commercial |
$6.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$565.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.06
|
| Rate for Payer: Healthscope Commercial |
$7.19
|
| Rate for Payer: Healthscope Commercial |
$726.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$686.44
|
| Rate for Payer: PHP Commercial |
$6.79
|
| Rate for Payer: PHP Commercial |
$686.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.19
|
| Rate for Payer: Priority Health SBD |
$508.78
|
| Rate for Payer: Priority Health SBD |
$5.03
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION
|
Facility
|
OP
|
$807.58
|
|
|
Service Code
|
HCPCS J7510
|
| Hospital Charge Code |
29302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$323.03 |
| Max. Negotiated Rate |
$726.82 |
| Rate for Payer: Aetna Commercial |
$686.44
|
| Rate for Payer: Aetna Commercial |
$6.79
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Aetna Medicare |
$403.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.93
|
| Rate for Payer: BCBS Complete |
$323.03
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: Cash Price |
$6.39
|
| Rate for Payer: Cash Price |
$646.06
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Cofinity Commercial |
$565.31
|
| Rate for Payer: Cofinity Commercial |
$694.52
|
| Rate for Payer: Cofinity Commercial |
$6.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$565.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.06
|
| Rate for Payer: Healthscope Commercial |
$7.19
|
| Rate for Payer: Healthscope Commercial |
$726.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$686.44
|
| Rate for Payer: PHP Commercial |
$686.44
|
| Rate for Payer: PHP Commercial |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.93
|
| Rate for Payer: Priority Health SBD |
$508.78
|
| Rate for Payer: Priority Health SBD |
$5.03
|
|
|
PREDNISONE 10 MG TABLET
|
Facility
|
OP
|
$425.35
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6494
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$170.14 |
| Max. Negotiated Rate |
$382.81 |
| Rate for Payer: Aetna Commercial |
$361.55
|
| Rate for Payer: Aetna Commercial |
$323.60
|
| Rate for Payer: Aetna Commercial |
$39.75
|
| Rate for Payer: Aetna Commercial |
$183.77
|
| Rate for Payer: Aetna Commercial |
$235.71
|
| Rate for Payer: Aetna Medicare |
$190.35
|
| Rate for Payer: Aetna Medicare |
$23.39
|
| Rate for Payer: Aetna Medicare |
$212.68
|
| Rate for Payer: Aetna Medicare |
$138.65
|
| Rate for Payer: Aetna Medicare |
$108.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.53
|
| Rate for Payer: BCBS Complete |
$110.92
|
| Rate for Payer: BCBS Complete |
$170.14
|
| Rate for Payer: BCBS Complete |
$152.28
|
| Rate for Payer: BCBS Complete |
$86.48
|
| Rate for Payer: BCBS Complete |
$18.71
|
| Rate for Payer: Cash Price |
$172.96
|
| Rate for Payer: Cash Price |
$304.56
|
| Rate for Payer: Cash Price |
$37.42
|
| Rate for Payer: Cash Price |
$221.84
|
| Rate for Payer: Cash Price |
$340.28
|
| Rate for Payer: Cofinity Commercial |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$151.34
|
| Rate for Payer: Cofinity Commercial |
$185.93
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$238.48
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Cofinity Commercial |
$327.40
|
| Rate for Payer: Cofinity Commercial |
$297.75
|
| Rate for Payer: Cofinity Commercial |
$32.74
|
| Rate for Payer: Cofinity Commercial |
$40.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$151.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.84
|
| Rate for Payer: Healthscope Commercial |
$249.57
|
| Rate for Payer: Healthscope Commercial |
$194.58
|
| Rate for Payer: Healthscope Commercial |
$382.81
|
| Rate for Payer: Healthscope Commercial |
$42.09
|
| Rate for Payer: Healthscope Commercial |
$342.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.75
|
| Rate for Payer: PHP Commercial |
$361.55
|
| Rate for Payer: PHP Commercial |
$323.60
|
| Rate for Payer: PHP Commercial |
$235.71
|
| Rate for Payer: PHP Commercial |
$183.77
|
| Rate for Payer: PHP Commercial |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.46
|
| Rate for Payer: Priority Health SBD |
$29.47
|
| Rate for Payer: Priority Health SBD |
$136.21
|
| Rate for Payer: Priority Health SBD |
$174.70
|
| Rate for Payer: Priority Health SBD |
$267.97
|
| Rate for Payer: Priority Health SBD |
$239.84
|
|
|
PREDNISONE 10 MG TABLET
|
Facility
|
IP
|
$216.20
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6494
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$136.21 |
| Max. Negotiated Rate |
$194.58 |
| Rate for Payer: Aetna Commercial |
$183.77
|
| Rate for Payer: Aetna Commercial |
$235.71
|
| Rate for Payer: Aetna Commercial |
$323.60
|
| Rate for Payer: Aetna Commercial |
$361.55
|
| Rate for Payer: Aetna Commercial |
$39.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.25
|
| Rate for Payer: Cash Price |
$37.42
|
| Rate for Payer: Cash Price |
$221.84
|
| Rate for Payer: Cash Price |
$340.28
|
| Rate for Payer: Cash Price |
$304.56
|
| Rate for Payer: Cash Price |
$172.96
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$151.34
|
| Rate for Payer: Cofinity Commercial |
$185.93
|
| Rate for Payer: Cofinity Commercial |
$40.22
|
| Rate for Payer: Cofinity Commercial |
$32.74
|
| Rate for Payer: Cofinity Commercial |
$238.48
|
| Rate for Payer: Cofinity Commercial |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$297.75
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Cofinity Commercial |
$327.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$151.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.42
|
| Rate for Payer: Healthscope Commercial |
$342.63
|
| Rate for Payer: Healthscope Commercial |
$249.57
|
| Rate for Payer: Healthscope Commercial |
$194.58
|
| Rate for Payer: Healthscope Commercial |
$382.81
|
| Rate for Payer: Healthscope Commercial |
$42.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.77
|
| Rate for Payer: PHP Commercial |
$361.55
|
| Rate for Payer: PHP Commercial |
$39.75
|
| Rate for Payer: PHP Commercial |
$323.60
|
| Rate for Payer: PHP Commercial |
$235.71
|
| Rate for Payer: PHP Commercial |
$183.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.48
|
| Rate for Payer: Priority Health SBD |
$267.97
|
| Rate for Payer: Priority Health SBD |
$174.70
|
| Rate for Payer: Priority Health SBD |
$239.84
|
| Rate for Payer: Priority Health SBD |
$136.21
|
| Rate for Payer: Priority Health SBD |
$29.47
|
|
|
PREDNISONE 10 MG TABLETS IN A DOSE PACK
|
Facility
|
OP
|
$86.39
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
15853
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.56 |
| Max. Negotiated Rate |
$77.75 |
| Rate for Payer: Aetna Commercial |
$73.43
|
| Rate for Payer: Aetna Medicare |
$43.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.15
|
| Rate for Payer: BCBS Complete |
$34.56
|
| Rate for Payer: Cash Price |
$69.11
|
| Rate for Payer: Cofinity Commercial |
$60.47
|
| Rate for Payer: Cofinity Commercial |
$74.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.11
|
| Rate for Payer: Healthscope Commercial |
$77.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.43
|
| Rate for Payer: PHP Commercial |
$73.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.15
|
| Rate for Payer: Priority Health SBD |
$54.43
|
|
|
PREDNISONE 10 MG TABLETS IN A DOSE PACK
|
Facility
|
IP
|
$86.39
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
15853
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.43 |
| Max. Negotiated Rate |
$77.75 |
| Rate for Payer: Aetna Commercial |
$73.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.15
|
| Rate for Payer: Cash Price |
$69.11
|
| Rate for Payer: Cofinity Commercial |
$60.47
|
| Rate for Payer: Cofinity Commercial |
$74.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.11
|
| Rate for Payer: Healthscope Commercial |
$77.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.43
|
| Rate for Payer: PHP Commercial |
$73.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.15
|
| Rate for Payer: Priority Health SBD |
$54.43
|
|
|
PREDNISONE 1 MG TABLET
|
Facility
|
IP
|
$218.55
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6493
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.69 |
| Max. Negotiated Rate |
$196.69 |
| Rate for Payer: Aetna Commercial |
$185.77
|
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: Aetna Commercial |
$135.83
|
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: Cash Price |
$174.84
|
| Rate for Payer: Cash Price |
$127.84
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cash Price |
$157.32
|
| Rate for Payer: Cofinity Commercial |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Cofinity Commercial |
$111.86
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Cofinity Commercial |
$152.99
|
| Rate for Payer: Cofinity Commercial |
$187.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
| Rate for Payer: Healthscope Commercial |
$143.82
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Healthscope Commercial |
$176.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.83
|
| Rate for Payer: PHP Commercial |
$167.15
|
| Rate for Payer: PHP Commercial |
$185.77
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: PHP Commercial |
$135.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.82
|
| Rate for Payer: Priority Health SBD |
$137.69
|
| Rate for Payer: Priority Health SBD |
$100.67
|
| Rate for Payer: Priority Health SBD |
$123.89
|
| Rate for Payer: Priority Health SBD |
$278.33
|
|
|
PREDNISONE 1 MG TABLET
|
Facility
|
OP
|
$218.55
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6493
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.42 |
| Max. Negotiated Rate |
$196.69 |
| Rate for Payer: Aetna Commercial |
$185.77
|
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: Aetna Commercial |
$375.53
|
| Rate for Payer: Aetna Commercial |
$135.83
|
| Rate for Payer: Aetna Medicare |
$220.90
|
| Rate for Payer: Aetna Medicare |
$109.28
|
| Rate for Payer: Aetna Medicare |
$98.33
|
| Rate for Payer: Aetna Medicare |
$79.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.17
|
| Rate for Payer: BCBS Complete |
$63.92
|
| Rate for Payer: BCBS Complete |
$176.72
|
| Rate for Payer: BCBS Complete |
$78.66
|
| Rate for Payer: BCBS Complete |
$87.42
|
| Rate for Payer: Cash Price |
$353.44
|
| Rate for Payer: Cash Price |
$157.32
|
| Rate for Payer: Cash Price |
$174.84
|
| Rate for Payer: Cash Price |
$127.84
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Cofinity Commercial |
$379.95
|
| Rate for Payer: Cofinity Commercial |
$152.99
|
| Rate for Payer: Cofinity Commercial |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$187.95
|
| Rate for Payer: Cofinity Commercial |
$111.86
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
| Rate for Payer: Healthscope Commercial |
$143.82
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Healthscope Commercial |
$176.99
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.83
|
| Rate for Payer: PHP Commercial |
$167.15
|
| Rate for Payer: PHP Commercial |
$375.53
|
| Rate for Payer: PHP Commercial |
$185.77
|
| Rate for Payer: PHP Commercial |
$135.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.17
|
| Rate for Payer: Priority Health SBD |
$100.67
|
| Rate for Payer: Priority Health SBD |
$137.69
|
| Rate for Payer: Priority Health SBD |
$123.89
|
| Rate for Payer: Priority Health SBD |
$278.33
|
|
|
PREDNISONE 20 MG TABLET
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6496
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Commercial |
$17.12
|
| Rate for Payer: Aetna Commercial |
$1,717.85
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna Commercial |
$393.51
|
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna Medicare |
$196.22
|
| Rate for Payer: Aetna Medicare |
$1,010.50
|
| Rate for Payer: Aetna Medicare |
$231.47
|
| Rate for Payer: Aetna Medicare |
$1.97
|
| Rate for Payer: Aetna Medicare |
$10.07
|
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.20
|
| Rate for Payer: BCBS Complete |
$181.42
|
| Rate for Payer: BCBS Complete |
$8.06
|
| Rate for Payer: BCBS Complete |
$156.98
|
| Rate for Payer: BCBS Complete |
$808.40
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS Complete |
$1.57
|
| Rate for Payer: BCBS Complete |
$185.18
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cash Price |
$370.36
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$1,616.80
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cash Price |
$16.11
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$1,414.70
|
| Rate for Payer: Cofinity Commercial |
$1,738.06
|
| Rate for Payer: Cofinity Commercial |
$274.71
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Cofinity Commercial |
$398.14
|
| Rate for Payer: Cofinity Commercial |
$324.06
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Cofinity Commercial |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Cofinity Commercial |
$17.32
|
| Rate for Payer: Cofinity Commercial |
$14.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,414.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$274.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Healthscope Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$18.13
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$1,818.90
|
| Rate for Payer: Healthscope Commercial |
$416.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,717.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.58
|
| Rate for Payer: PHP Commercial |
$159.80
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: PHP Commercial |
$1,717.85
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$393.51
|
| Rate for Payer: PHP Commercial |
$17.12
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,313.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.55
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: Priority Health SBD |
$1,273.23
|
| Rate for Payer: Priority Health SBD |
$291.66
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: Priority Health SBD |
$12.69
|
| Rate for Payer: Priority Health SBD |
$118.44
|
| Rate for Payer: Priority Health SBD |
$2.48
|
|
|
PREDNISONE 20 MG TABLET
|
Facility
|
IP
|
$453.55
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6496
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$285.74 |
| Max. Negotiated Rate |
$408.19 |
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna Commercial |
$17.12
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Commercial |
$1,717.85
|
| Rate for Payer: Aetna Commercial |
$393.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.55
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cash Price |
$16.11
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cash Price |
$370.36
|
| Rate for Payer: Cash Price |
$1,616.80
|
| Rate for Payer: Cofinity Commercial |
$324.06
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Commercial |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Cofinity Commercial |
$14.10
|
| Rate for Payer: Cofinity Commercial |
$17.32
|
| Rate for Payer: Cofinity Commercial |
$1,414.70
|
| Rate for Payer: Cofinity Commercial |
$1,738.06
|
| Rate for Payer: Cofinity Commercial |
$274.71
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$398.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$274.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,414.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$18.13
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$1,818.90
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Healthscope Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$416.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,717.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.51
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$1,717.85
|
| Rate for Payer: PHP Commercial |
$159.80
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: PHP Commercial |
$17.12
|
| Rate for Payer: PHP Commercial |
$393.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,313.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.09
|
| Rate for Payer: Priority Health SBD |
$2.48
|
| Rate for Payer: Priority Health SBD |
$12.69
|
| Rate for Payer: Priority Health SBD |
$291.66
|
| Rate for Payer: Priority Health SBD |
$118.44
|
| Rate for Payer: Priority Health SBD |
$1,273.23
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: Priority Health SBD |
$285.74
|
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
IP
|
$287.85
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$181.35 |
| Max. Negotiated Rate |
$259.06 |
| Rate for Payer: Aetna Commercial |
$244.67
|
| Rate for Payer: Aetna Commercial |
$194.61
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: Cash Price |
$183.16
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cash Price |
$230.28
|
| Rate for Payer: Cofinity Commercial |
$160.26
|
| Rate for Payer: Cofinity Commercial |
$196.90
|
| Rate for Payer: Cofinity Commercial |
$201.50
|
| Rate for Payer: Cofinity Commercial |
$247.55
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Healthscope Commercial |
$206.06
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$244.67
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$194.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.82
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: Priority Health SBD |
$181.35
|
| Rate for Payer: Priority Health SBD |
$144.24
|
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
OP
|
$228.95
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$91.58 |
| Max. Negotiated Rate |
$206.06 |
| Rate for Payer: Aetna Commercial |
$194.61
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna Commercial |
$244.67
|
| Rate for Payer: Aetna Medicare |
$148.20
|
| Rate for Payer: Aetna Medicare |
$114.47
|
| Rate for Payer: Aetna Medicare |
$143.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.10
|
| Rate for Payer: BCBS Complete |
$115.14
|
| Rate for Payer: BCBS Complete |
$91.58
|
| Rate for Payer: BCBS Complete |
$118.56
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cash Price |
$183.16
|
| Rate for Payer: Cash Price |
$230.28
|
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Commercial |
$196.90
|
| Rate for Payer: Cofinity Commercial |
$160.26
|
| Rate for Payer: Cofinity Commercial |
$247.55
|
| Rate for Payer: Cofinity Commercial |
$201.50
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.16
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Commercial |
$206.06
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.61
|
| Rate for Payer: PHP Commercial |
$244.67
|
| Rate for Payer: PHP Commercial |
$194.61
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.10
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: Priority Health SBD |
$181.35
|
| Rate for Payer: Priority Health SBD |
$144.24
|
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
OP
|
$43.48
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$39.13 |
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna Medicare |
$21.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: BCBS Complete |
$17.39
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.26
|
| Rate for Payer: Priority Health SBD |
$27.39
|
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
IP
|
$43.48
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.39 |
| Max. Negotiated Rate |
$39.13 |
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.26
|
| Rate for Payer: Priority Health SBD |
$27.39
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 98961
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Medicare |
$11.50
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 98962
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: Aetna Medicare |
$8.50
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 98960
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
|
|
PR EEG,ALL NIGHT RECORD
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
HCPCS 95827
|
| Min. Negotiated Rate |
$538.00 |
| Max. Negotiated Rate |
$874.25 |
| Rate for Payer: Aetna Medicare |
$672.50
|
| Rate for Payer: BCBS Complete |
$538.00
|
| Rate for Payer: Cash Price |
$1,076.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$874.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.25
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 95721
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$356.55 |
| Rate for Payer: Aetna Commercial |
$258.26
|
| Rate for Payer: Aetna Medicare |
$200.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.53
|
| Rate for Payer: BCBS Complete |
$171.20
|
| Rate for Payer: BCBS MAPPO |
$192.73
|
| Rate for Payer: BCN Medicare Advantage |
$192.73
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cofinity Commercial |
$277.53
|
| Rate for Payer: Cofinity Commercial |
$258.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.73
|
| Rate for Payer: Healthscope Commercial |
$308.37
|
| Rate for Payer: Healthscope Commercial |
$356.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.20
|
| Rate for Payer: Nomi Health Commercial |
$231.28
|
| Rate for Payer: PACE SWMI |
$192.73
|
| Rate for Payer: PHP Medicare Advantage |
$192.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.20
|
| Rate for Payer: Priority Health Medicare |
$192.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.73
|
| Rate for Payer: UHC Medicare Advantage |
$192.73
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 95722
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$434.40 |
| Rate for Payer: Aetna Commercial |
$314.65
|
| Rate for Payer: Aetna Medicare |
$244.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.65
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$234.81
|
| Rate for Payer: BCN Medicare Advantage |
$234.81
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$338.13
|
| Rate for Payer: Cofinity Commercial |
$314.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.81
|
| Rate for Payer: Healthscope Commercial |
$434.40
|
| Rate for Payer: Healthscope Commercial |
$375.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.00
|
| Rate for Payer: Nomi Health Commercial |
$281.77
|
| Rate for Payer: PACE SWMI |
$234.81
|
| Rate for Payer: PHP Medicare Advantage |
$234.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$234.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.81
|
| Rate for Payer: UHC Medicare Advantage |
$234.81
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 95723
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$438.49 |
| Rate for Payer: Aetna Commercial |
$317.61
|
| Rate for Payer: Aetna Medicare |
$246.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.61
|
| Rate for Payer: BCBS Complete |
$212.40
|
| Rate for Payer: BCBS MAPPO |
$237.02
|
| Rate for Payer: BCN Medicare Advantage |
$237.02
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$341.31
|
| Rate for Payer: Cofinity Commercial |
$317.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.02
|
| Rate for Payer: Healthscope Commercial |
$379.23
|
| Rate for Payer: Healthscope Commercial |
$438.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.15
|
| Rate for Payer: Nomi Health Commercial |
$284.42
|
| Rate for Payer: PACE SWMI |
$237.02
|
| Rate for Payer: PHP Medicare Advantage |
$237.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.15
|
| Rate for Payer: Priority Health Medicare |
$237.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.02
|
| Rate for Payer: UHC Medicare Advantage |
$237.02
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 95724
|
| Min. Negotiated Rate |
$265.60 |
| Max. Negotiated Rate |
$551.37 |
| Rate for Payer: Aetna Commercial |
$399.37
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.37
|
| Rate for Payer: BCBS Complete |
$265.60
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$429.18
|
| Rate for Payer: Cofinity Commercial |
$399.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$551.37
|
| Rate for Payer: Healthscope Commercial |
$476.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.60
|
| Rate for Payer: Nomi Health Commercial |
$357.65
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/O VID
|
Professional
|
Both
|
$607.00
|
|
|
Service Code
|
HCPCS 95725
|
| Min. Negotiated Rate |
$242.80 |
| Max. Negotiated Rate |
$502.31 |
| Rate for Payer: Aetna Commercial |
$363.84
|
| Rate for Payer: Aetna Medicare |
$282.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$363.84
|
| Rate for Payer: BCBS Complete |
$242.80
|
| Rate for Payer: BCBS MAPPO |
$271.52
|
| Rate for Payer: BCN Medicare Advantage |
$271.52
|
| Rate for Payer: Cash Price |
$485.60
|
| Rate for Payer: Cash Price |
$485.60
|
| Rate for Payer: Cofinity Commercial |
$390.99
|
| Rate for Payer: Cofinity Commercial |
$363.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.52
|
| Rate for Payer: Healthscope Commercial |
$434.43
|
| Rate for Payer: Healthscope Commercial |
$502.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: Nomi Health Commercial |
$325.82
|
| Rate for Payer: PACE SWMI |
$271.52
|
| Rate for Payer: PHP Medicare Advantage |
$271.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.55
|
| Rate for Payer: Priority Health Medicare |
$271.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.52
|
| Rate for Payer: UHC Medicare Advantage |
$271.52
|
|
