ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$57.10
|
|
Service Code
|
HCPCS J1650
|
Hospital Charge Code |
31921
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$34.83 |
Max. Negotiated Rate |
$51.39 |
Rate for Payer: Aetna Commercial |
$48.54
|
Rate for Payer: Aetna Commercial |
$44.08
|
Rate for Payer: Aetna Commercial |
$79.15
|
Rate for Payer: BCBS Trust/PPO |
$44.13
|
Rate for Payer: BCBS Trust/PPO |
$40.08
|
Rate for Payer: BCBS Trust/PPO |
$71.96
|
Rate for Payer: BCN Commercial |
$40.08
|
Rate for Payer: BCN Commercial |
$71.96
|
Rate for Payer: BCN Commercial |
$44.13
|
Rate for Payer: Cash Price |
$41.49
|
Rate for Payer: Cash Price |
$74.50
|
Rate for Payer: Cash Price |
$45.68
|
Rate for Payer: Cofinity Commercial |
$49.11
|
Rate for Payer: Cofinity Commercial |
$44.60
|
Rate for Payer: Cofinity Commercial |
$80.08
|
Rate for Payer: Encore Health Key Benefits Commercial |
$41.49
|
Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
Rate for Payer: Healthscope Commercial |
$83.81
|
Rate for Payer: Healthscope Commercial |
$46.67
|
Rate for Payer: Healthscope Commercial |
$51.39
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.90
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.15
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.08
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.54
|
Rate for Payer: PHP Commercial |
$44.08
|
Rate for Payer: PHP Commercial |
$79.15
|
Rate for Payer: PHP Commercial |
$48.54
|
Rate for Payer: Priority Health Cigna Priority Health |
$36.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$39.97
|
Rate for Payer: Priority Health Cigna Priority Health |
$65.18
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.01
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.68
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$31.63
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$34.83
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.79
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$81.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$45.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$50.25
|
Rate for Payer: UHC Core |
$77.76
|
Rate for Payer: UHC Core |
$47.68
|
Rate for Payer: UHC Core |
$43.30
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.90
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.82
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$18.61
|
|
Service Code
|
HCPCS J1650
|
Hospital Charge Code |
105899
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$11.35 |
Max. Negotiated Rate |
$16.75 |
Rate for Payer: Aetna Commercial |
$15.82
|
Rate for Payer: Aetna Commercial |
$13.71
|
Rate for Payer: Aetna Commercial |
$26.18
|
Rate for Payer: Aetna Commercial |
$23.61
|
Rate for Payer: Aetna Commercial |
$13.87
|
Rate for Payer: Aetna Commercial |
$22.57
|
Rate for Payer: Aetna Commercial |
$20.97
|
Rate for Payer: Aetna Commercial |
$18.46
|
Rate for Payer: Aetna Commercial |
$15.66
|
Rate for Payer: BCBS Trust/PPO |
$12.61
|
Rate for Payer: BCBS Trust/PPO |
$16.79
|
Rate for Payer: BCBS Trust/PPO |
$14.38
|
Rate for Payer: BCBS Trust/PPO |
$21.47
|
Rate for Payer: BCBS Trust/PPO |
$23.80
|
Rate for Payer: BCBS Trust/PPO |
$12.47
|
Rate for Payer: BCBS Trust/PPO |
$19.06
|
Rate for Payer: BCBS Trust/PPO |
$14.23
|
Rate for Payer: BCBS Trust/PPO |
$20.52
|
Rate for Payer: BCN Commercial |
$12.61
|
Rate for Payer: BCN Commercial |
$12.47
|
Rate for Payer: BCN Commercial |
$14.38
|
Rate for Payer: BCN Commercial |
$23.80
|
Rate for Payer: BCN Commercial |
$14.23
|
Rate for Payer: BCN Commercial |
$16.79
|
Rate for Payer: BCN Commercial |
$21.47
|
Rate for Payer: BCN Commercial |
$20.52
|
Rate for Payer: BCN Commercial |
$19.06
|
Rate for Payer: Cash Price |
$19.74
|
Rate for Payer: Cash Price |
$14.89
|
Rate for Payer: Cash Price |
$21.24
|
Rate for Payer: Cash Price |
$13.06
|
Rate for Payer: Cash Price |
$14.74
|
Rate for Payer: Cash Price |
$22.22
|
Rate for Payer: Cash Price |
$17.38
|
Rate for Payer: Cash Price |
$12.90
|
Rate for Payer: Cash Price |
$24.64
|
Rate for Payer: Cofinity Commercial |
$14.04
|
Rate for Payer: Cofinity Commercial |
$13.87
|
Rate for Payer: Cofinity Commercial |
$15.84
|
Rate for Payer: Cofinity Commercial |
$16.00
|
Rate for Payer: Cofinity Commercial |
$18.68
|
Rate for Payer: Cofinity Commercial |
$21.22
|
Rate for Payer: Cofinity Commercial |
$22.83
|
Rate for Payer: Cofinity Commercial |
$23.89
|
Rate for Payer: Cofinity Commercial |
$26.49
|
Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$21.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$17.38
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$14.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$24.64
|
Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
Rate for Payer: Healthscope Commercial |
$14.52
|
Rate for Payer: Healthscope Commercial |
$25.00
|
Rate for Payer: Healthscope Commercial |
$19.55
|
Rate for Payer: Healthscope Commercial |
$16.58
|
Rate for Payer: Healthscope Commercial |
$27.72
|
Rate for Payer: Healthscope Commercial |
$16.75
|
Rate for Payer: Healthscope Commercial |
$23.90
|
Rate for Payer: Healthscope Commercial |
$22.20
|
Rate for Payer: Healthscope Commercial |
$14.69
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.29
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.24
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.87
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.18
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.97
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.46
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.61
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.57
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.71
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.66
|
Rate for Payer: PHP Commercial |
$15.66
|
Rate for Payer: PHP Commercial |
$18.46
|
Rate for Payer: PHP Commercial |
$23.61
|
Rate for Payer: PHP Commercial |
$13.87
|
Rate for Payer: PHP Commercial |
$15.82
|
Rate for Payer: PHP Commercial |
$22.57
|
Rate for Payer: PHP Commercial |
$20.97
|
Rate for Payer: PHP Commercial |
$26.18
|
Rate for Payer: PHP Commercial |
$13.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$19.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$18.58
|
Rate for Payer: Priority Health Cigna Priority Health |
$21.56
|
Rate for Payer: Priority Health Cigna Priority Health |
$15.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$12.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$11.29
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$11.42
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.19
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.03
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.46
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.03
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.17
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.80
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$13.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$16.19
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$9.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$16.94
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$18.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$19.11
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$23.36
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.71
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$14.36
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$16.38
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$27.10
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$16.21
|
Rate for Payer: UHC Core |
$18.14
|
Rate for Payer: UHC Core |
$23.20
|
Rate for Payer: UHC Core |
$25.72
|
Rate for Payer: UHC Core |
$13.63
|
Rate for Payer: UHC Core |
$13.47
|
Rate for Payer: UHC Core |
$22.17
|
Rate for Payer: UHC Core |
$15.54
|
Rate for Payer: UHC Core |
$20.60
|
Rate for Payer: UHC Core |
$15.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.10
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.10
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.24
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.29
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.50
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$19.62
|
|
Service Code
|
HCPCS J1650
|
Hospital Charge Code |
105900
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$11.97 |
Max. Negotiated Rate |
$17.66 |
Rate for Payer: Aetna Commercial |
$16.68
|
Rate for Payer: Aetna Commercial |
$21.56
|
Rate for Payer: Aetna Commercial |
$21.07
|
Rate for Payer: Aetna Commercial |
$21.14
|
Rate for Payer: Aetna Commercial |
$30.04
|
Rate for Payer: Aetna Commercial |
$21.12
|
Rate for Payer: Aetna Commercial |
$34.91
|
Rate for Payer: Aetna Commercial |
$16.84
|
Rate for Payer: BCBS Trust/PPO |
$15.31
|
Rate for Payer: BCBS Trust/PPO |
$15.16
|
Rate for Payer: BCBS Trust/PPO |
$27.31
|
Rate for Payer: BCBS Trust/PPO |
$19.61
|
Rate for Payer: BCBS Trust/PPO |
$19.22
|
Rate for Payer: BCBS Trust/PPO |
$19.16
|
Rate for Payer: BCBS Trust/PPO |
$31.74
|
Rate for Payer: BCBS Trust/PPO |
$19.20
|
Rate for Payer: BCN Commercial |
$15.16
|
Rate for Payer: BCN Commercial |
$15.31
|
Rate for Payer: BCN Commercial |
$19.16
|
Rate for Payer: BCN Commercial |
$19.20
|
Rate for Payer: BCN Commercial |
$19.22
|
Rate for Payer: BCN Commercial |
$19.61
|
Rate for Payer: BCN Commercial |
$31.74
|
Rate for Payer: BCN Commercial |
$27.31
|
Rate for Payer: Cash Price |
$15.85
|
Rate for Payer: Cash Price |
$32.86
|
Rate for Payer: Cash Price |
$19.83
|
Rate for Payer: Cash Price |
$20.30
|
Rate for Payer: Cash Price |
$15.70
|
Rate for Payer: Cash Price |
$19.90
|
Rate for Payer: Cash Price |
$28.27
|
Rate for Payer: Cash Price |
$19.88
|
Rate for Payer: Cofinity Commercial |
$30.39
|
Rate for Payer: Cofinity Commercial |
$16.87
|
Rate for Payer: Cofinity Commercial |
$35.32
|
Rate for Payer: Cofinity Commercial |
$21.32
|
Rate for Payer: Cofinity Commercial |
$21.37
|
Rate for Payer: Cofinity Commercial |
$21.82
|
Rate for Payer: Cofinity Commercial |
$21.39
|
Rate for Payer: Cofinity Commercial |
$17.04
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$15.85
|
Rate for Payer: Encore Health Key Benefits Commercial |
$28.27
|
Rate for Payer: Encore Health Key Benefits Commercial |
$32.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.88
|
Rate for Payer: Encore Health Key Benefits Commercial |
$15.70
|
Rate for Payer: Healthscope Commercial |
$17.83
|
Rate for Payer: Healthscope Commercial |
$22.36
|
Rate for Payer: Healthscope Commercial |
$22.83
|
Rate for Payer: Healthscope Commercial |
$36.96
|
Rate for Payer: Healthscope Commercial |
$17.66
|
Rate for Payer: Healthscope Commercial |
$22.38
|
Rate for Payer: Healthscope Commercial |
$31.81
|
Rate for Payer: Healthscope Commercial |
$22.31
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.86
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.59
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.64
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.03
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.91
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.04
|
Rate for Payer: PHP Commercial |
$21.56
|
Rate for Payer: PHP Commercial |
$21.14
|
Rate for Payer: PHP Commercial |
$21.07
|
Rate for Payer: PHP Commercial |
$21.12
|
Rate for Payer: PHP Commercial |
$30.04
|
Rate for Payer: PHP Commercial |
$34.91
|
Rate for Payer: PHP Commercial |
$16.68
|
Rate for Payer: PHP Commercial |
$16.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$28.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.87
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.57
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.07
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.75
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.73
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.64
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.07
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.08
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.17
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.16
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$25.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.47
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.12
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.55
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.97
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$31.10
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.82
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.87
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.89
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$22.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$36.14
|
Rate for Payer: UHC Core |
$20.77
|
Rate for Payer: UHC Core |
$20.70
|
Rate for Payer: UHC Core |
$21.18
|
Rate for Payer: UHC Core |
$16.54
|
Rate for Payer: UHC Core |
$20.75
|
Rate for Payer: UHC Core |
$16.38
|
Rate for Payer: UHC Core |
$34.29
|
Rate for Payer: UHC Core |
$29.51
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.80
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.64
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.59
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.72
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$20.13
|
|
Service Code
|
HCPCS J1650
|
Hospital Charge Code |
105901
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$12.28 |
Max. Negotiated Rate |
$18.12 |
Rate for Payer: Aetna Commercial |
$17.11
|
Rate for Payer: Aetna Commercial |
$15.38
|
Rate for Payer: Aetna Commercial |
$18.50
|
Rate for Payer: BCBS Trust/PPO |
$15.56
|
Rate for Payer: BCBS Trust/PPO |
$13.98
|
Rate for Payer: BCBS Trust/PPO |
$16.82
|
Rate for Payer: BCN Commercial |
$16.82
|
Rate for Payer: BCN Commercial |
$15.56
|
Rate for Payer: BCN Commercial |
$13.98
|
Rate for Payer: Cash Price |
$16.10
|
Rate for Payer: Cash Price |
$14.47
|
Rate for Payer: Cash Price |
$17.42
|
Rate for Payer: Cofinity Commercial |
$17.31
|
Rate for Payer: Cofinity Commercial |
$15.56
|
Rate for Payer: Cofinity Commercial |
$18.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.10
|
Rate for Payer: Encore Health Key Benefits Commercial |
$14.47
|
Rate for Payer: Healthscope Commercial |
$16.28
|
Rate for Payer: Healthscope Commercial |
$18.12
|
Rate for Payer: Healthscope Commercial |
$19.59
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.33
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.57
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.11
|
Rate for Payer: PHP Commercial |
$17.11
|
Rate for Payer: PHP Commercial |
$15.38
|
Rate for Payer: PHP Commercial |
$18.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$12.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$15.24
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.51
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.94
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.74
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.03
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$13.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$15.92
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.71
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$19.16
|
Rate for Payer: UHC Core |
$15.11
|
Rate for Payer: UHC Core |
$18.18
|
Rate for Payer: UHC Core |
$16.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.33
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.57
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.10
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$82.23
|
|
Service Code
|
HCPCS J1650
|
Hospital Charge Code |
105902
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$50.15 |
Max. Negotiated Rate |
$74.01 |
Rate for Payer: Aetna Commercial |
$69.90
|
Rate for Payer: Aetna Commercial |
$42.22
|
Rate for Payer: Aetna Commercial |
$21.84
|
Rate for Payer: BCBS Trust/PPO |
$19.85
|
Rate for Payer: BCBS Trust/PPO |
$63.55
|
Rate for Payer: BCBS Trust/PPO |
$38.38
|
Rate for Payer: BCN Commercial |
$63.55
|
Rate for Payer: BCN Commercial |
$19.85
|
Rate for Payer: BCN Commercial |
$38.38
|
Rate for Payer: Cash Price |
$20.55
|
Rate for Payer: Cash Price |
$39.74
|
Rate for Payer: Cash Price |
$65.78
|
Rate for Payer: Cofinity Commercial |
$70.72
|
Rate for Payer: Cofinity Commercial |
$22.09
|
Rate for Payer: Cofinity Commercial |
$42.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$65.78
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.55
|
Rate for Payer: Healthscope Commercial |
$44.70
|
Rate for Payer: Healthscope Commercial |
$74.01
|
Rate for Payer: Healthscope Commercial |
$23.12
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.67
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.27
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.22
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.90
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.84
|
Rate for Payer: PHP Commercial |
$42.22
|
Rate for Payer: PHP Commercial |
$69.90
|
Rate for Payer: PHP Commercial |
$21.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$34.77
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.98
|
Rate for Payer: Priority Health Cigna Priority Health |
$57.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.54
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.21
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.67
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$50.15
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$30.29
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$72.36
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$43.71
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$22.61
|
Rate for Payer: UHC Core |
$21.45
|
Rate for Payer: UHC Core |
$41.47
|
Rate for Payer: UHC Core |
$68.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.67
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.27
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.25
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$14.17
|
|
Service Code
|
NDC 60687-188-11
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$8.64 |
Max. Negotiated Rate |
$12.75 |
Rate for Payer: Aetna Commercial |
$12.04
|
Rate for Payer: BCBS Trust/PPO |
$10.95
|
Rate for Payer: BCN Commercial |
$10.95
|
Rate for Payer: Cash Price |
$11.34
|
Rate for Payer: Cofinity Commercial |
$12.19
|
Rate for Payer: Encore Health Key Benefits Commercial |
$11.34
|
Rate for Payer: Healthscope Commercial |
$12.75
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.63
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.04
|
Rate for Payer: PHP Commercial |
$12.04
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.92
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.33
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$8.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$12.47
|
Rate for Payer: UHC Core |
$11.83
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.63
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$250.08
|
|
Service Code
|
NDC 65862-654-01
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$152.52 |
Max. Negotiated Rate |
$225.07 |
Rate for Payer: Aetna Commercial |
$212.57
|
Rate for Payer: BCBS Trust/PPO |
$193.26
|
Rate for Payer: BCN Commercial |
$193.26
|
Rate for Payer: Cash Price |
$200.06
|
Rate for Payer: Cofinity Commercial |
$215.07
|
Rate for Payer: Encore Health Key Benefits Commercial |
$200.06
|
Rate for Payer: Healthscope Commercial |
$225.07
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.57
|
Rate for Payer: PHP Commercial |
$212.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$175.06
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.57
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$152.52
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$220.07
|
Rate for Payer: UHC Core |
$208.82
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.56
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$13.43
|
|
Service Code
|
NDC 50268-295-11
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$8.19 |
Max. Negotiated Rate |
$12.09 |
Rate for Payer: Aetna Commercial |
$11.42
|
Rate for Payer: BCBS Trust/PPO |
$10.38
|
Rate for Payer: BCN Commercial |
$10.38
|
Rate for Payer: Cash Price |
$10.74
|
Rate for Payer: Cofinity Commercial |
$11.55
|
Rate for Payer: Encore Health Key Benefits Commercial |
$10.74
|
Rate for Payer: Healthscope Commercial |
$12.09
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.42
|
Rate for Payer: PHP Commercial |
$11.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.68
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$8.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$11.82
|
Rate for Payer: UHC Core |
$11.21
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.07
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$425.02
|
|
Service Code
|
NDC 60687-188-21
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$259.22 |
Max. Negotiated Rate |
$382.52 |
Rate for Payer: Aetna Commercial |
$361.27
|
Rate for Payer: BCBS Trust/PPO |
$328.46
|
Rate for Payer: BCN Commercial |
$328.46
|
Rate for Payer: Cash Price |
$340.02
|
Rate for Payer: Cofinity Commercial |
$365.52
|
Rate for Payer: Encore Health Key Benefits Commercial |
$340.02
|
Rate for Payer: Healthscope Commercial |
$382.52
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.76
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$361.27
|
Rate for Payer: PHP Commercial |
$361.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$297.51
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.77
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$259.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$374.02
|
Rate for Payer: UHC Core |
$354.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.76
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$671.37
|
|
Service Code
|
NDC 50268-295-15
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$409.47 |
Max. Negotiated Rate |
$604.23 |
Rate for Payer: Aetna Commercial |
$570.66
|
Rate for Payer: BCBS Trust/PPO |
$518.83
|
Rate for Payer: BCN Commercial |
$518.83
|
Rate for Payer: Cash Price |
$537.10
|
Rate for Payer: Cofinity Commercial |
$577.38
|
Rate for Payer: Encore Health Key Benefits Commercial |
$537.10
|
Rate for Payer: Healthscope Commercial |
$604.23
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.53
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.66
|
Rate for Payer: PHP Commercial |
$570.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$469.96
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.09
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$409.47
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$590.81
|
Rate for Payer: UHC Core |
$560.59
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.53
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$1,308.69
|
|
Service Code
|
NDC 47335-007-88
|
Hospital Charge Code |
26547
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$798.17 |
Max. Negotiated Rate |
$1,177.82 |
Rate for Payer: Aetna Commercial |
$1,112.39
|
Rate for Payer: BCBS Trust/PPO |
$1,011.36
|
Rate for Payer: BCN Commercial |
$1,011.36
|
Rate for Payer: Cash Price |
$1,046.95
|
Rate for Payer: Cofinity Commercial |
$1,125.47
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,046.95
|
Rate for Payer: Healthscope Commercial |
$1,177.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$981.52
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,112.39
|
Rate for Payer: PHP Commercial |
$1,112.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$916.08
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.56
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$798.17
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,151.65
|
Rate for Payer: UHC Core |
$1,092.76
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$981.52
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$85.17
|
|
Service Code
|
NDC 17478-415-10
|
Hospital Charge Code |
300142
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$51.95 |
Max. Negotiated Rate |
$76.65 |
Rate for Payer: Aetna Commercial |
$72.39
|
Rate for Payer: BCBS Trust/PPO |
$65.82
|
Rate for Payer: BCN Commercial |
$65.82
|
Rate for Payer: Cash Price |
$68.14
|
Rate for Payer: Cofinity Commercial |
$73.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$68.14
|
Rate for Payer: Healthscope Commercial |
$76.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.39
|
Rate for Payer: PHP Commercial |
$72.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$59.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.10
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$51.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$74.95
|
Rate for Payer: UHC Core |
$71.12
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.88
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$18.75
|
|
Service Code
|
NDC 70756-611-82
|
Hospital Charge Code |
300142
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$11.44 |
Max. Negotiated Rate |
$16.88 |
Rate for Payer: Aetna Commercial |
$15.94
|
Rate for Payer: BCBS Trust/PPO |
$14.49
|
Rate for Payer: BCN Commercial |
$14.49
|
Rate for Payer: Cash Price |
$15.00
|
Rate for Payer: Cofinity Commercial |
$16.12
|
Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
Rate for Payer: Healthscope Commercial |
$16.88
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.94
|
Rate for Payer: PHP Commercial |
$15.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
Rate for Payer: UHC Core |
$15.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$18.75
|
|
Service Code
|
NDC 70756-611-25
|
Hospital Charge Code |
300142
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$11.44 |
Max. Negotiated Rate |
$16.88 |
Rate for Payer: Aetna Commercial |
$15.94
|
Rate for Payer: BCBS Trust/PPO |
$14.49
|
Rate for Payer: BCN Commercial |
$14.49
|
Rate for Payer: Cash Price |
$15.00
|
Rate for Payer: Cofinity Commercial |
$16.12
|
Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
Rate for Payer: Healthscope Commercial |
$16.88
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.94
|
Rate for Payer: PHP Commercial |
$15.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
Rate for Payer: UHC Core |
$15.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
|
EPHEDRINE SULFATE 50 MG/ML INJECTION WRAPPER
|
Facility
|
IP
|
$85.17
|
|
Service Code
|
NDC 17478-955-10
|
Hospital Charge Code |
300142
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$51.95 |
Max. Negotiated Rate |
$76.65 |
Rate for Payer: Aetna Commercial |
$72.39
|
Rate for Payer: BCBS Trust/PPO |
$65.82
|
Rate for Payer: BCN Commercial |
$65.82
|
Rate for Payer: Cash Price |
$68.14
|
Rate for Payer: Cofinity Commercial |
$73.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$68.14
|
Rate for Payer: Healthscope Commercial |
$76.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.39
|
Rate for Payer: PHP Commercial |
$72.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$59.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.10
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$51.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$74.95
|
Rate for Payer: UHC Core |
$71.12
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.88
|
|
EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.75
|
|
Service Code
|
HCPCS J3490
|
Hospital Charge Code |
179024
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$11.44 |
Max. Negotiated Rate |
$16.88 |
Rate for Payer: Aetna Commercial |
$15.94
|
Rate for Payer: BCBS Trust/PPO |
$14.49
|
Rate for Payer: BCN Commercial |
$14.49
|
Rate for Payer: Cash Price |
$15.00
|
Rate for Payer: Cofinity Commercial |
$16.12
|
Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
Rate for Payer: Healthscope Commercial |
$16.88
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.94
|
Rate for Payer: PHP Commercial |
$15.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$13.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$11.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
Rate for Payer: UHC Core |
$15.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
|
EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$35.60
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
2848
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$21.71 |
Max. Negotiated Rate |
$32.04 |
Rate for Payer: Aetna Commercial |
$30.26
|
Rate for Payer: Aetna Commercial |
$17.37
|
Rate for Payer: Aetna Commercial |
$33.29
|
Rate for Payer: BCBS Trust/PPO |
$27.51
|
Rate for Payer: BCBS Trust/PPO |
$15.79
|
Rate for Payer: BCBS Trust/PPO |
$30.26
|
Rate for Payer: BCN Commercial |
$15.79
|
Rate for Payer: BCN Commercial |
$30.26
|
Rate for Payer: BCN Commercial |
$27.51
|
Rate for Payer: Cash Price |
$16.34
|
Rate for Payer: Cash Price |
$28.48
|
Rate for Payer: Cash Price |
$31.33
|
Rate for Payer: Cofinity Commercial |
$17.57
|
Rate for Payer: Cofinity Commercial |
$33.68
|
Rate for Payer: Cofinity Commercial |
$30.62
|
Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
Rate for Payer: Encore Health Key Benefits Commercial |
$31.33
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.34
|
Rate for Payer: Healthscope Commercial |
$18.39
|
Rate for Payer: Healthscope Commercial |
$32.04
|
Rate for Payer: Healthscope Commercial |
$35.24
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.32
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.37
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.70
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.37
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.26
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.29
|
Rate for Payer: PHP Commercial |
$33.29
|
Rate for Payer: PHP Commercial |
$30.26
|
Rate for Payer: PHP Commercial |
$17.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.92
|
Rate for Payer: Priority Health Cigna Priority Health |
$27.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.97
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.07
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$23.88
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.71
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$34.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$31.33
|
Rate for Payer: UHC Core |
$17.06
|
Rate for Payer: UHC Core |
$29.73
|
Rate for Payer: UHC Core |
$32.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.32
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.37
|
|
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
|
Facility
|
IP
|
$1,793.09
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
100491
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1,093.61 |
Max. Negotiated Rate |
$1,613.78 |
Rate for Payer: Aetna Commercial |
$1,524.13
|
Rate for Payer: Aetna Commercial |
$845.42
|
Rate for Payer: BCBS Trust/PPO |
$768.63
|
Rate for Payer: BCBS Trust/PPO |
$1,385.70
|
Rate for Payer: BCN Commercial |
$1,385.70
|
Rate for Payer: BCN Commercial |
$768.63
|
Rate for Payer: Cash Price |
$795.69
|
Rate for Payer: Cash Price |
$1,434.47
|
Rate for Payer: Cofinity Commercial |
$1,542.06
|
Rate for Payer: Cofinity Commercial |
$855.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$795.69
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,434.47
|
Rate for Payer: Healthscope Commercial |
$1,613.78
|
Rate for Payer: Healthscope Commercial |
$895.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.96
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$845.42
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,524.13
|
Rate for Payer: PHP Commercial |
$1,524.13
|
Rate for Payer: PHP Commercial |
$845.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,255.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$696.23
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.99
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$865.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,093.61
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$606.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$875.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,577.92
|
Rate for Payer: UHC Core |
$1,497.23
|
Rate for Payer: UHC Core |
$830.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.82
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.96
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$20.73
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
152715
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$12.64 |
Max. Negotiated Rate |
$18.66 |
Rate for Payer: Aetna Commercial |
$17.62
|
Rate for Payer: Aetna Commercial |
$49.25
|
Rate for Payer: BCBS Trust/PPO |
$44.78
|
Rate for Payer: BCBS Trust/PPO |
$16.02
|
Rate for Payer: BCN Commercial |
$44.78
|
Rate for Payer: BCN Commercial |
$16.02
|
Rate for Payer: Cash Price |
$16.58
|
Rate for Payer: Cash Price |
$46.35
|
Rate for Payer: Cofinity Commercial |
$17.83
|
Rate for Payer: Cofinity Commercial |
$49.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.58
|
Rate for Payer: Healthscope Commercial |
$18.66
|
Rate for Payer: Healthscope Commercial |
$52.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.46
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.62
|
Rate for Payer: PHP Commercial |
$49.25
|
Rate for Payer: PHP Commercial |
$17.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$40.56
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.41
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.04
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$35.34
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$50.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$18.24
|
Rate for Payer: UHC Core |
$17.31
|
Rate for Payer: UHC Core |
$48.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.46
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$582.67
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
2850
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$355.37 |
Max. Negotiated Rate |
$524.40 |
Rate for Payer: Aetna Commercial |
$495.27
|
Rate for Payer: Aetna Commercial |
$477.07
|
Rate for Payer: BCBS Trust/PPO |
$433.74
|
Rate for Payer: BCBS Trust/PPO |
$450.29
|
Rate for Payer: BCN Commercial |
$433.74
|
Rate for Payer: BCN Commercial |
$450.29
|
Rate for Payer: Cash Price |
$466.14
|
Rate for Payer: Cash Price |
$449.01
|
Rate for Payer: Cofinity Commercial |
$501.10
|
Rate for Payer: Cofinity Commercial |
$482.68
|
Rate for Payer: Encore Health Key Benefits Commercial |
$449.01
|
Rate for Payer: Encore Health Key Benefits Commercial |
$466.14
|
Rate for Payer: Healthscope Commercial |
$505.13
|
Rate for Payer: Healthscope Commercial |
$524.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$477.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$495.27
|
Rate for Payer: PHP Commercial |
$477.07
|
Rate for Payer: PHP Commercial |
$495.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$392.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$407.87
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$342.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$355.37
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$493.91
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$512.75
|
Rate for Payer: UHC Core |
$486.53
|
Rate for Payer: UHC Core |
$468.65
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.94
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.00
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
IP
|
$62.31
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
181607
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$38.00 |
Max. Negotiated Rate |
$56.08 |
Rate for Payer: Aetna Commercial |
$52.96
|
Rate for Payer: BCBS Trust/PPO |
$48.15
|
Rate for Payer: BCN Commercial |
$48.15
|
Rate for Payer: Cash Price |
$49.85
|
Rate for Payer: Cofinity Commercial |
$53.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
Rate for Payer: Healthscope Commercial |
$56.08
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.73
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.96
|
Rate for Payer: PHP Commercial |
$52.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$43.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.21
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$38.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$54.83
|
Rate for Payer: UHC Core |
$52.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.73
|
|
EPINEPHRINE HCL 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$35.60
|
|
Service Code
|
HCPCS J0171
|
Hospital Charge Code |
163700
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$21.71 |
Max. Negotiated Rate |
$32.04 |
Rate for Payer: Aetna Commercial |
$30.26
|
Rate for Payer: Aetna Commercial |
$17.37
|
Rate for Payer: BCBS Trust/PPO |
$27.51
|
Rate for Payer: BCBS Trust/PPO |
$15.79
|
Rate for Payer: BCN Commercial |
$27.51
|
Rate for Payer: BCN Commercial |
$15.79
|
Rate for Payer: Cash Price |
$16.34
|
Rate for Payer: Cash Price |
$28.48
|
Rate for Payer: Cofinity Commercial |
$17.57
|
Rate for Payer: Cofinity Commercial |
$30.62
|
Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.34
|
Rate for Payer: Healthscope Commercial |
$18.39
|
Rate for Payer: Healthscope Commercial |
$32.04
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.70
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.26
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.37
|
Rate for Payer: PHP Commercial |
$30.26
|
Rate for Payer: PHP Commercial |
$17.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.92
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.71
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$31.33
|
Rate for Payer: UHC Core |
$17.06
|
Rate for Payer: UHC Core |
$29.73
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.32
|
|
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,948.33
|
|
Service Code
|
HCPCS J1327
|
Hospital Charge Code |
23123
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1,188.29 |
Max. Negotiated Rate |
$1,753.50 |
Rate for Payer: Aetna Commercial |
$1,656.08
|
Rate for Payer: Aetna Commercial |
$1,631.66
|
Rate for Payer: Aetna Commercial |
$216.53
|
Rate for Payer: BCBS Trust/PPO |
$1,505.67
|
Rate for Payer: BCBS Trust/PPO |
$1,483.47
|
Rate for Payer: BCBS Trust/PPO |
$196.86
|
Rate for Payer: BCN Commercial |
$1,483.47
|
Rate for Payer: BCN Commercial |
$196.86
|
Rate for Payer: BCN Commercial |
$1,505.67
|
Rate for Payer: Cash Price |
$1,535.68
|
Rate for Payer: Cash Price |
$1,558.66
|
Rate for Payer: Cash Price |
$203.79
|
Rate for Payer: Cofinity Commercial |
$1,650.86
|
Rate for Payer: Cofinity Commercial |
$219.08
|
Rate for Payer: Cofinity Commercial |
$1,675.56
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,558.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$203.79
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,535.68
|
Rate for Payer: Healthscope Commercial |
$1,727.64
|
Rate for Payer: Healthscope Commercial |
$1,753.50
|
Rate for Payer: Healthscope Commercial |
$229.27
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,439.70
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.06
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,631.66
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,656.08
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.53
|
Rate for Payer: PHP Commercial |
$216.53
|
Rate for Payer: PHP Commercial |
$1,656.08
|
Rate for Payer: PHP Commercial |
$1,631.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,363.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$178.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,343.72
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,670.05
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,695.05
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$155.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,188.29
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,170.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,689.25
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$224.17
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,714.53
|
Rate for Payer: UHC Core |
$1,602.87
|
Rate for Payer: UHC Core |
$1,626.86
|
Rate for Payer: UHC Core |
$212.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,439.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.06
|
|
EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$568.57
|
|
Service Code
|
HCPCS J1327
|
Hospital Charge Code |
23124
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$346.77 |
Max. Negotiated Rate |
$511.71 |
Rate for Payer: Aetna Commercial |
$483.28
|
Rate for Payer: BCBS Trust/PPO |
$439.39
|
Rate for Payer: BCN Commercial |
$439.39
|
Rate for Payer: Cash Price |
$454.86
|
Rate for Payer: Cofinity Commercial |
$488.97
|
Rate for Payer: Encore Health Key Benefits Commercial |
$454.86
|
Rate for Payer: Healthscope Commercial |
$511.71
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$426.43
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$483.28
|
Rate for Payer: PHP Commercial |
$483.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$398.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.66
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$346.77
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$500.34
|
Rate for Payer: UHC Core |
$474.76
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$426.43
|
|
ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE
|
Facility
|
IP
|
$258.50
|
|
Service Code
|
NDC 64380-737-06
|
Hospital Charge Code |
2863
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$157.66 |
Max. Negotiated Rate |
$232.65 |
Rate for Payer: Aetna Commercial |
$219.72
|
Rate for Payer: BCBS Trust/PPO |
$199.77
|
Rate for Payer: BCN Commercial |
$199.77
|
Rate for Payer: Cash Price |
$206.80
|
Rate for Payer: Cofinity Commercial |
$222.31
|
Rate for Payer: Encore Health Key Benefits Commercial |
$206.80
|
Rate for Payer: Healthscope Commercial |
$232.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.72
|
Rate for Payer: PHP Commercial |
$219.72
|
Rate for Payer: Priority Health Cigna Priority Health |
$180.95
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.90
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$157.66
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$227.48
|
Rate for Payer: UHC Core |
$215.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.88
|
|