|
METHOCARBAMOL 500 MG TABLET
|
Facility
|
IP
|
$446.50
|
|
|
Service Code
|
NDC 0904-7057-61
|
| Hospital Charge Code |
4971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$272.32 |
| Max. Negotiated Rate |
$401.85 |
| Rate for Payer: Aetna Commercial |
$379.52
|
| Rate for Payer: BCBS Trust/PPO |
$345.06
|
| Rate for Payer: BCN Commercial |
$345.06
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Commercial |
$383.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$401.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$379.52
|
| Rate for Payer: PHP Commercial |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$388.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.92
|
| Rate for Payer: UHC Core |
$372.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.88
|
|
|
METHOCARBAMOL 500 MG TABLET
|
Facility
|
IP
|
$2.07
|
|
|
Service Code
|
NDC 60687-559-11
|
| Hospital Charge Code |
4971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$1.86 |
| Rate for Payer: Aetna Commercial |
$1.76
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: Cash Price |
$1.66
|
| Rate for Payer: Cofinity Commercial |
$1.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.66
|
| Rate for Payer: Healthscope Commercial |
$1.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.76
|
| Rate for Payer: PHP Commercial |
$1.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.82
|
| Rate for Payer: UHC Core |
$1.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.55
|
|
|
METHOCARBAMOL 500 MG TABLET
|
Facility
|
IP
|
$206.15
|
|
|
Service Code
|
NDC 60687-559-01
|
| Hospital Charge Code |
4971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$185.54 |
| Rate for Payer: Aetna Commercial |
$175.23
|
| Rate for Payer: BCBS Trust/PPO |
$159.31
|
| Rate for Payer: BCN Commercial |
$159.31
|
| Rate for Payer: Cash Price |
$164.92
|
| Rate for Payer: Cofinity Commercial |
$177.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.92
|
| Rate for Payer: Healthscope Commercial |
$185.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.23
|
| Rate for Payer: PHP Commercial |
$175.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.41
|
| Rate for Payer: UHC Core |
$172.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.61
|
|
|
METHOCARBAMOL 750 MG TABLET
|
Facility
|
IP
|
$224.20
|
|
|
Service Code
|
NDC 0904-7058-61
|
| Hospital Charge Code |
4972
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.74 |
| Max. Negotiated Rate |
$201.78 |
| Rate for Payer: Aetna Commercial |
$190.57
|
| Rate for Payer: BCBS Trust/PPO |
$173.26
|
| Rate for Payer: BCN Commercial |
$173.26
|
| Rate for Payer: Cash Price |
$179.36
|
| Rate for Payer: Cofinity Commercial |
$192.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.36
|
| Rate for Payer: Healthscope Commercial |
$201.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$190.57
|
| Rate for Payer: PHP Commercial |
$190.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.30
|
| Rate for Payer: UHC Core |
$187.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.15
|
|
|
METHOTREXATE SODIUM 2.5 MG TABLET
|
Facility
|
IP
|
$163.84
|
|
|
Service Code
|
HCPCS J8610
|
| Hospital Charge Code |
4973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$99.93 |
| Max. Negotiated Rate |
$147.46 |
| Rate for Payer: Aetna Commercial |
$139.26
|
| Rate for Payer: Aetna Commercial |
$7.78
|
| Rate for Payer: Aetna Commercial |
$155.43
|
| Rate for Payer: BCBS Trust/PPO |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$126.62
|
| Rate for Payer: BCBS Trust/PPO |
$141.31
|
| Rate for Payer: BCN Commercial |
$7.07
|
| Rate for Payer: BCN Commercial |
$141.31
|
| Rate for Payer: BCN Commercial |
$126.62
|
| Rate for Payer: Cash Price |
$131.07
|
| Rate for Payer: Cash Price |
$7.32
|
| Rate for Payer: Cash Price |
$146.29
|
| Rate for Payer: Cofinity Commercial |
$157.26
|
| Rate for Payer: Cofinity Commercial |
$140.90
|
| Rate for Payer: Cofinity Commercial |
$7.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.29
|
| Rate for Payer: Healthscope Commercial |
$164.57
|
| Rate for Payer: Healthscope Commercial |
$8.24
|
| Rate for Payer: Healthscope Commercial |
$147.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.78
|
| Rate for Payer: PHP Commercial |
$139.26
|
| Rate for Payer: PHP Commercial |
$155.43
|
| Rate for Payer: PHP Commercial |
$7.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.05
|
| Rate for Payer: UHC Core |
$136.81
|
| Rate for Payer: UHC Core |
$152.69
|
| Rate for Payer: UHC Core |
$7.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.86
|
|
|
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$74.08
|
|
|
Service Code
|
NDC 17478-504-01
|
| Hospital Charge Code |
4985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$66.67 |
| Rate for Payer: Aetna Commercial |
$62.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.25
|
| Rate for Payer: BCN Commercial |
$57.25
|
| Rate for Payer: Cash Price |
$59.26
|
| Rate for Payer: Cofinity Commercial |
$63.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.26
|
| Rate for Payer: Healthscope Commercial |
$66.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.97
|
| Rate for Payer: PHP Commercial |
$62.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.19
|
| Rate for Payer: UHC Core |
$61.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.56
|
|
|
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$590.90
|
|
|
Service Code
|
NDC 17478-504-10
|
| Hospital Charge Code |
4985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$360.39 |
| Max. Negotiated Rate |
$531.81 |
| Rate for Payer: Aetna Commercial |
$502.26
|
| Rate for Payer: BCBS Trust/PPO |
$456.65
|
| Rate for Payer: BCN Commercial |
$456.65
|
| Rate for Payer: Cash Price |
$472.72
|
| Rate for Payer: Cofinity Commercial |
$508.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.72
|
| Rate for Payer: Healthscope Commercial |
$531.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$502.26
|
| Rate for Payer: PHP Commercial |
$502.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Core |
$493.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.18
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$662.29
|
|
|
Service Code
|
NDC 0517-0374-05
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$403.93 |
| Max. Negotiated Rate |
$596.06 |
| Rate for Payer: Aetna Commercial |
$562.95
|
| Rate for Payer: BCBS Trust/PPO |
$511.82
|
| Rate for Payer: BCN Commercial |
$511.82
|
| Rate for Payer: Cash Price |
$529.83
|
| Rate for Payer: Cofinity Commercial |
$569.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.83
|
| Rate for Payer: Healthscope Commercial |
$596.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$562.95
|
| Rate for Payer: PHP Commercial |
$562.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$463.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.82
|
| Rate for Payer: UHC Core |
$553.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.72
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$662.29
|
|
|
Service Code
|
NDC 0517-0374-01
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$403.93 |
| Max. Negotiated Rate |
$596.06 |
| Rate for Payer: Aetna Commercial |
$562.95
|
| Rate for Payer: BCBS Trust/PPO |
$511.82
|
| Rate for Payer: BCN Commercial |
$511.82
|
| Rate for Payer: Cash Price |
$529.83
|
| Rate for Payer: Cofinity Commercial |
$569.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.83
|
| Rate for Payer: Healthscope Commercial |
$596.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$562.95
|
| Rate for Payer: PHP Commercial |
$562.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$463.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.82
|
| Rate for Payer: UHC Core |
$553.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.72
|
|
|
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$68.08
|
|
|
Service Code
|
HCPCS J2210
|
| Hospital Charge Code |
10571
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.52 |
| Max. Negotiated Rate |
$61.27 |
| Rate for Payer: Aetna Commercial |
$57.87
|
| Rate for Payer: Aetna Commercial |
$25.95
|
| Rate for Payer: BCBS Trust/PPO |
$52.61
|
| Rate for Payer: BCBS Trust/PPO |
$23.59
|
| Rate for Payer: BCN Commercial |
$52.61
|
| Rate for Payer: BCN Commercial |
$23.59
|
| Rate for Payer: Cash Price |
$54.46
|
| Rate for Payer: Cash Price |
$24.42
|
| Rate for Payer: Cofinity Commercial |
$58.55
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.46
|
| Rate for Payer: Healthscope Commercial |
$27.48
|
| Rate for Payer: Healthscope Commercial |
$61.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.87
|
| Rate for Payer: PHP Commercial |
$57.87
|
| Rate for Payer: PHP Commercial |
$25.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.91
|
| Rate for Payer: UHC Core |
$25.49
|
| Rate for Payer: UHC Core |
$56.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.90
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$507.90
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
91651
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$309.77 |
| Max. Negotiated Rate |
$457.11 |
| Rate for Payer: Aetna Commercial |
$431.72
|
| Rate for Payer: BCBS Trust/PPO |
$392.51
|
| Rate for Payer: BCN Commercial |
$392.51
|
| Rate for Payer: Cash Price |
$406.32
|
| Rate for Payer: Cofinity Commercial |
$436.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.32
|
| Rate for Payer: Healthscope Commercial |
$457.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.72
|
| Rate for Payer: PHP Commercial |
$431.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$441.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$309.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.95
|
| Rate for Payer: UHC Core |
$424.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.92
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$320.25
|
|
|
Service Code
|
NDC 0406-1142-01
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.32 |
| Max. Negotiated Rate |
$288.22 |
| Rate for Payer: Aetna Commercial |
$272.21
|
| Rate for Payer: BCBS Trust/PPO |
$247.49
|
| Rate for Payer: BCN Commercial |
$247.49
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Healthscope Commercial |
$288.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.21
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.82
|
| Rate for Payer: UHC Core |
$267.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.19
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$162.75
|
|
|
Service Code
|
NDC 10702-100-01
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$146.48 |
| Rate for Payer: Aetna Commercial |
$138.34
|
| Rate for Payer: BCBS Trust/PPO |
$125.77
|
| Rate for Payer: BCN Commercial |
$125.77
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cofinity Commercial |
$139.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.20
|
| Rate for Payer: Healthscope Commercial |
$146.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.34
|
| Rate for Payer: PHP Commercial |
$138.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.22
|
| Rate for Payer: UHC Core |
$135.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.06
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$357.63
|
|
|
Service Code
|
NDC 68084-805-21
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$218.12 |
| Max. Negotiated Rate |
$321.87 |
| Rate for Payer: Aetna Commercial |
$303.99
|
| Rate for Payer: BCBS Trust/PPO |
$276.38
|
| Rate for Payer: BCN Commercial |
$276.38
|
| Rate for Payer: Cash Price |
$286.10
|
| Rate for Payer: Cofinity Commercial |
$307.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.10
|
| Rate for Payer: Healthscope Commercial |
$321.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$303.99
|
| Rate for Payer: PHP Commercial |
$303.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.71
|
| Rate for Payer: UHC Core |
$298.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.22
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$11.93
|
|
|
Service Code
|
NDC 68084-805-11
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$10.74 |
| Rate for Payer: Aetna Commercial |
$10.14
|
| Rate for Payer: BCBS Trust/PPO |
$9.22
|
| Rate for Payer: BCN Commercial |
$9.22
|
| Rate for Payer: Cash Price |
$9.54
|
| Rate for Payer: Cofinity Commercial |
$10.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.54
|
| Rate for Payer: Healthscope Commercial |
$10.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.14
|
| Rate for Payer: PHP Commercial |
$10.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.50
|
| Rate for Payer: UHC Core |
$9.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.95
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
IP
|
$268.85
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$163.97 |
| Max. Negotiated Rate |
$241.96 |
| Rate for Payer: Aetna Commercial |
$228.52
|
| Rate for Payer: Aetna Commercial |
$213.18
|
| Rate for Payer: Aetna Commercial |
$540.60
|
| Rate for Payer: BCBS Trust/PPO |
$491.50
|
| Rate for Payer: BCBS Trust/PPO |
$207.77
|
| Rate for Payer: BCBS Trust/PPO |
$193.82
|
| Rate for Payer: BCN Commercial |
$193.82
|
| Rate for Payer: BCN Commercial |
$207.77
|
| Rate for Payer: BCN Commercial |
$491.50
|
| Rate for Payer: Cash Price |
$200.64
|
| Rate for Payer: Cash Price |
$215.08
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cofinity Commercial |
$546.96
|
| Rate for Payer: Cofinity Commercial |
$215.69
|
| Rate for Payer: Cofinity Commercial |
$231.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.64
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Healthscope Commercial |
$572.40
|
| Rate for Payer: Healthscope Commercial |
$241.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$540.60
|
| Rate for Payer: PHP Commercial |
$540.60
|
| Rate for Payer: PHP Commercial |
$228.52
|
| Rate for Payer: PHP Commercial |
$213.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.68
|
| Rate for Payer: UHC Core |
$224.49
|
| Rate for Payer: UHC Core |
$209.42
|
| Rate for Payer: UHC Core |
$531.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.64
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$30.63
|
|
|
Service Code
|
HCPCS J1030
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$27.57 |
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Commercial |
$21.90
|
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: BCBS Trust/PPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$27.83
|
| Rate for Payer: BCBS Trust/PPO |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$23.66
|
| Rate for Payer: BCN Commercial |
$23.67
|
| Rate for Payer: BCN Commercial |
$27.83
|
| Rate for Payer: BCN Commercial |
$19.91
|
| Rate for Payer: BCN Commercial |
$23.66
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$20.61
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Cofinity Commercial |
$22.15
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$23.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.04
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$21.90
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC Core |
$25.58
|
| Rate for Payer: UHC Core |
$25.57
|
| Rate for Payer: UHC Core |
$21.51
|
| Rate for Payer: UHC Core |
$30.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.97
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$58.66
|
|
|
Service Code
|
HCPCS J1040
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$52.79 |
| Rate for Payer: Aetna Commercial |
$49.86
|
| Rate for Payer: Aetna Commercial |
$50.31
|
| Rate for Payer: Aetna Commercial |
$161.48
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$45.74
|
| Rate for Payer: BCBS Trust/PPO |
$146.82
|
| Rate for Payer: BCBS Trust/PPO |
$20.02
|
| Rate for Payer: BCBS Trust/PPO |
$45.33
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: BCN Commercial |
$146.82
|
| Rate for Payer: BCN Commercial |
$45.33
|
| Rate for Payer: BCN Commercial |
$20.02
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$151.98
|
| Rate for Payer: Cash Price |
$47.35
|
| Rate for Payer: Cash Price |
$46.93
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Cofinity Commercial |
$50.90
|
| Rate for Payer: Cofinity Commercial |
$163.38
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.35
|
| Rate for Payer: Healthscope Commercial |
$52.79
|
| Rate for Payer: Healthscope Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$170.98
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.86
|
| Rate for Payer: PHP Commercial |
$161.48
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$49.86
|
| Rate for Payer: PHP Commercial |
$50.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.18
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Core |
$158.63
|
| Rate for Payer: UHC Core |
$48.98
|
| Rate for Payer: UHC Core |
$49.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.00
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$54.21
|
|
|
Service Code
|
HCPCS J2930
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.06 |
| Max. Negotiated Rate |
$48.79 |
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$154.52
|
| Rate for Payer: BCBS Trust/PPO |
$109.43
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCBS Trust/PPO |
$140.49
|
| Rate for Payer: BCBS Trust/PPO |
$41.89
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: BCN Commercial |
$41.89
|
| Rate for Payer: BCN Commercial |
$109.43
|
| Rate for Payer: BCN Commercial |
$140.49
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$145.43
|
| Rate for Payer: Cofinity Commercial |
$156.34
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$163.61
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$120.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.08
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$154.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.70
|
| Rate for Payer: UHC Core |
$118.24
|
| Rate for Payer: UHC Core |
$28.80
|
| Rate for Payer: UHC Core |
$151.79
|
| Rate for Payer: UHC Core |
$45.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.66
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$48.18
|
|
|
Service Code
|
HCPCS J2930
|
| Hospital Charge Code |
10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.38 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: BCBS Trust/PPO |
$37.23
|
| Rate for Payer: BCN Commercial |
$37.23
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.95
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.40
|
| Rate for Payer: UHC Core |
$40.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.14
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.70
|
|
|
Service Code
|
HCPCS J2920
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.19 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.20
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.52
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$100.26
|
|
|
Service Code
|
HCPCS J2930
|
| Hospital Charge Code |
10581
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.15 |
| Max. Negotiated Rate |
$90.23 |
| Rate for Payer: Aetna Commercial |
$85.22
|
| Rate for Payer: BCBS Trust/PPO |
$77.48
|
| Rate for Payer: BCN Commercial |
$77.48
|
| Rate for Payer: Cash Price |
$80.21
|
| Rate for Payer: Cofinity Commercial |
$86.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.21
|
| Rate for Payer: Healthscope Commercial |
$90.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.22
|
| Rate for Payer: PHP Commercial |
$85.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.23
|
| Rate for Payer: UHC Core |
$83.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.20
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)
|
Facility
|
IP
|
$31.75
|
|
|
Service Code
|
HCPCS J2930
|
| Hospital Charge Code |
163731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$28.58 |
| Rate for Payer: Aetna Commercial |
$26.99
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$27.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$28.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.99
|
| Rate for Payer: PHP Commercial |
$26.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.94
|
| Rate for Payer: UHC Core |
$26.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.81
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$31.75
|
|
|
Service Code
|
HCPCS J2930
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$28.58 |
| Rate for Payer: Aetna Commercial |
$26.99
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$27.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$28.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.99
|
| Rate for Payer: PHP Commercial |
$26.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.94
|
| Rate for Payer: UHC Core |
$26.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.81
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$19.95
|
|
|
Service Code
|
HCPCS J2920
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$17.96 |
| Rate for Payer: Aetna Commercial |
$16.96
|
| Rate for Payer: BCBS Trust/PPO |
$15.42
|
| Rate for Payer: BCN Commercial |
$15.42
|
| Rate for Payer: Cash Price |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$17.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.96
|
| Rate for Payer: Healthscope Commercial |
$17.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.96
|
| Rate for Payer: PHP Commercial |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.56
|
| Rate for Payer: UHC Core |
$16.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.96
|
|
