|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$15.28
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
1743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$13.75 |
| Rate for Payer: Aetna Commercial |
$12.99
|
| Rate for Payer: Aetna Commercial |
$17.25
|
| Rate for Payer: Aetna Medicare |
$5.28
|
| Rate for Payer: Aetna Medicare |
$3.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.34
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS MAPPO |
$5.08
|
| Rate for Payer: BCBS Trust/PPO |
$12.56
|
| Rate for Payer: BCBS Trust/PPO |
$16.69
|
| Rate for Payer: BCN Commercial |
$16.69
|
| Rate for Payer: BCN Commercial |
$12.56
|
| Rate for Payer: BCN Medicare Advantage |
$5.08
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.22
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$13.14
|
| Rate for Payer: Cofinity Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.75
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.22
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.01
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.99
|
| Rate for Payer: Nomi Health Commercial |
$16.65
|
| Rate for Payer: Nomi Health Commercial |
$12.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.22
|
| Rate for Payer: PACE Senior Care Partners |
$4.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$5.08
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$12.99
|
| Rate for Payer: PHP Commercial |
$17.25
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: PHP Medicare Advantage |
$5.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.29
|
| Rate for Payer: Priority Health Medicare |
$5.13
|
| Rate for Payer: Priority Health Medicare |
$3.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.86
|
| Rate for Payer: UHC Core |
$16.95
|
| Rate for Payer: UHC Core |
$12.76
|
| Rate for Payer: UHC Exchange |
$5.08
|
| Rate for Payer: UHC Exchange |
$3.82
|
| Rate for Payer: UHC Medicaid |
$3.58
|
| Rate for Payer: UHC Medicaid |
$2.69
|
| Rate for Payer: UHC Medicare Advantage |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.08
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: VA VA |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.46
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.87 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: BCBS Trust/PPO |
$17.64
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Nomi Health Commercial |
$17.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.80
|
| Rate for Payer: UHC Core |
$17.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$5.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.67
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$5.34
|
| Rate for Payer: BCBS Trust/PPO |
$17.56
|
| Rate for Payer: BCN Commercial |
$17.56
|
| Rate for Payer: BCN Medicare Advantage |
$5.34
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.34
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.61
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Nomi Health Commercial |
$17.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PACE Senior Care Partners |
$5.07
|
| Rate for Payer: PACE SWMI |
$5.34
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.58
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.80
|
| Rate for Payer: UHC Core |
$17.84
|
| Rate for Payer: UHC Exchange |
$5.34
|
| Rate for Payer: UHC Medicaid |
$3.77
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$5.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$29.82
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$24.63
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.24
|
| Rate for Payer: UHC Core |
$24.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$29.82
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Medicare |
$7.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.32
|
| Rate for Payer: BCBS Complete |
$5.52
|
| Rate for Payer: BCBS MAPPO |
$7.46
|
| Rate for Payer: BCBS Trust/PPO |
$24.52
|
| Rate for Payer: BCN Commercial |
$24.52
|
| Rate for Payer: BCN Medicare Advantage |
$7.46
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.46
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: Mclaren Medicaid |
$5.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.83
|
| Rate for Payer: Meridian Medicaid |
$5.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PACE Senior Care Partners |
$7.08
|
| Rate for Payer: PACE SWMI |
$7.46
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.94
|
| Rate for Payer: Priority Health Medicare |
$7.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.75
|
| Rate for Payer: Railroad Medicare Medicare |
$7.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.24
|
| Rate for Payer: UHC Core |
$24.90
|
| Rate for Payer: UHC Exchange |
$7.46
|
| Rate for Payer: UHC Medicaid |
$5.26
|
| Rate for Payer: UHC Medicare Advantage |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$5.26
|
| Rate for Payer: VA VA |
$7.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$5.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.67
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$5.34
|
| Rate for Payer: BCBS Trust/PPO |
$17.56
|
| Rate for Payer: BCN Commercial |
$17.56
|
| Rate for Payer: BCN Medicare Advantage |
$5.34
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.34
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.61
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Nomi Health Commercial |
$17.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PACE Senior Care Partners |
$5.07
|
| Rate for Payer: PACE SWMI |
$5.34
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.58
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.80
|
| Rate for Payer: UHC Core |
$17.84
|
| Rate for Payer: UHC Exchange |
$5.34
|
| Rate for Payer: UHC Medicaid |
$3.77
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$5.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.87 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: BCBS Trust/PPO |
$17.64
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Nomi Health Commercial |
$17.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.80
|
| Rate for Payer: UHC Core |
$17.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.43 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Commercial |
$30.83
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCBS Trust/PPO |
$29.96
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$29.96
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cash Price |
$29.02
|
| Rate for Payer: Cofinity Commercial |
$31.19
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.83
|
| Rate for Payer: Nomi Health Commercial |
$21.71
|
| Rate for Payer: Nomi Health Commercial |
$29.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.20
|
| Rate for Payer: PHP Commercial |
$30.83
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.92
|
| Rate for Payer: UHC Core |
$22.11
|
| Rate for Payer: UHC Core |
$30.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
|
|
CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
9627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Commercial |
$30.83
|
| Rate for Payer: Aetna Medicare |
$9.43
|
| Rate for Payer: Aetna Medicare |
$6.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.33
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS Complete |
$6.71
|
| Rate for Payer: BCBS MAPPO |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$9.07
|
| Rate for Payer: BCBS Trust/PPO |
$21.77
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$29.82
|
| Rate for Payer: BCN Commercial |
$21.77
|
| Rate for Payer: BCN Medicare Advantage |
$9.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.62
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cash Price |
$29.02
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Commercial |
$31.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.62
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Mclaren Medicaid |
$6.39
|
| Rate for Payer: Mclaren Medicaid |
$4.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.95
|
| Rate for Payer: Meridian Medicaid |
$4.90
|
| Rate for Payer: Meridian Medicaid |
$6.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Nomi Health Commercial |
$29.74
|
| Rate for Payer: Nomi Health Commercial |
$21.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.20
|
| Rate for Payer: PACE Senior Care Partners |
$8.61
|
| Rate for Payer: PACE Senior Care Partners |
$6.29
|
| Rate for Payer: PACE SWMI |
$9.07
|
| Rate for Payer: PACE SWMI |
$6.62
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$30.83
|
| Rate for Payer: PHP Medicare Advantage |
$6.62
|
| Rate for Payer: PHP Medicare Advantage |
$9.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.04
|
| Rate for Payer: Priority Health Medicare |
$9.16
|
| Rate for Payer: Priority Health Medicare |
$6.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.24
|
| Rate for Payer: Railroad Medicare Medicare |
$6.62
|
| Rate for Payer: Railroad Medicare Medicare |
$9.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.92
|
| Rate for Payer: UHC Core |
$30.29
|
| Rate for Payer: UHC Core |
$22.11
|
| Rate for Payer: UHC Exchange |
$9.07
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicaid |
$6.39
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHC Medicare Advantage |
$6.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.07
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$6.39
|
| Rate for Payer: VA VA |
$6.62
|
| Rate for Payer: VA VA |
$9.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Commercial |
$30.83
|
| Rate for Payer: Aetna Medicare |
$9.43
|
| Rate for Payer: Aetna Medicare |
$6.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.33
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS Complete |
$6.71
|
| Rate for Payer: BCBS MAPPO |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$9.07
|
| Rate for Payer: BCBS Trust/PPO |
$21.77
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$29.82
|
| Rate for Payer: BCN Commercial |
$21.77
|
| Rate for Payer: BCN Medicare Advantage |
$9.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.62
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cash Price |
$29.02
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Commercial |
$31.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.62
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Mclaren Medicaid |
$6.39
|
| Rate for Payer: Mclaren Medicaid |
$4.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.95
|
| Rate for Payer: Meridian Medicaid |
$4.90
|
| Rate for Payer: Meridian Medicaid |
$6.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Nomi Health Commercial |
$29.74
|
| Rate for Payer: Nomi Health Commercial |
$21.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.20
|
| Rate for Payer: PACE Senior Care Partners |
$8.61
|
| Rate for Payer: PACE Senior Care Partners |
$6.29
|
| Rate for Payer: PACE SWMI |
$9.07
|
| Rate for Payer: PACE SWMI |
$6.62
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$30.83
|
| Rate for Payer: PHP Medicare Advantage |
$6.62
|
| Rate for Payer: PHP Medicare Advantage |
$9.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.04
|
| Rate for Payer: Priority Health Medicare |
$9.16
|
| Rate for Payer: Priority Health Medicare |
$6.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.24
|
| Rate for Payer: Railroad Medicare Medicare |
$6.62
|
| Rate for Payer: Railroad Medicare Medicare |
$9.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.92
|
| Rate for Payer: UHC Core |
$30.29
|
| Rate for Payer: UHC Core |
$22.11
|
| Rate for Payer: UHC Exchange |
$9.07
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicaid |
$6.39
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHC Medicare Advantage |
$6.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.07
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: UHCCP Medicaid |
$6.39
|
| Rate for Payer: VA VA |
$6.62
|
| Rate for Payer: VA VA |
$9.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.43 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Commercial |
$30.83
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCBS Trust/PPO |
$29.96
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$29.96
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cash Price |
$29.02
|
| Rate for Payer: Cofinity Commercial |
$31.19
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.83
|
| Rate for Payer: Nomi Health Commercial |
$21.71
|
| Rate for Payer: Nomi Health Commercial |
$29.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.20
|
| Rate for Payer: PHP Commercial |
$30.83
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.92
|
| Rate for Payer: UHC Core |
$22.11
|
| Rate for Payer: UHC Core |
$30.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$216.60
|
|
|
Service Code
|
NDC 68084024301
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.19 |
| Max. Negotiated Rate |
$194.94 |
| Rate for Payer: Aetna Commercial |
$184.11
|
| Rate for Payer: Aetna Medicare |
$56.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.69
|
| Rate for Payer: BCBS Complete |
$40.09
|
| Rate for Payer: BCBS MAPPO |
$54.15
|
| Rate for Payer: BCBS Trust/PPO |
$178.07
|
| Rate for Payer: BCN Commercial |
$178.07
|
| Rate for Payer: BCN Medicare Advantage |
$54.15
|
| Rate for Payer: Cash Price |
$173.28
|
| Rate for Payer: Cofinity Commercial |
$186.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.15
|
| Rate for Payer: Healthscope Commercial |
$194.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.45
|
| Rate for Payer: Mclaren Medicaid |
$38.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.86
|
| Rate for Payer: Meridian Medicaid |
$40.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.11
|
| Rate for Payer: Nomi Health Commercial |
$177.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.45
|
| Rate for Payer: PACE Senior Care Partners |
$51.44
|
| Rate for Payer: PACE SWMI |
$54.15
|
| Rate for Payer: PHP Commercial |
$184.11
|
| Rate for Payer: PHP Medicare Advantage |
$54.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.44
|
| Rate for Payer: Priority Health Medicare |
$54.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.75
|
| Rate for Payer: Railroad Medicare Medicare |
$54.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.61
|
| Rate for Payer: UHC Core |
$180.86
|
| Rate for Payer: UHC Exchange |
$54.15
|
| Rate for Payer: UHC Medicaid |
$38.19
|
| Rate for Payer: UHC Medicare Advantage |
$54.15
|
| Rate for Payer: UHCCP Medicaid |
$38.19
|
| Rate for Payer: VA VA |
$54.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.45
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$216.60
|
|
|
Service Code
|
NDC 68084024301
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.75 |
| Max. Negotiated Rate |
$194.94 |
| Rate for Payer: Aetna Commercial |
$184.11
|
| Rate for Payer: BCBS Trust/PPO |
$178.89
|
| Rate for Payer: BCN Commercial |
$178.89
|
| Rate for Payer: Cash Price |
$173.28
|
| Rate for Payer: Cofinity Commercial |
$186.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.28
|
| Rate for Payer: Healthscope Commercial |
$194.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.11
|
| Rate for Payer: Nomi Health Commercial |
$177.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.45
|
| Rate for Payer: PHP Commercial |
$184.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.61
|
| Rate for Payer: UHC Core |
$180.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.45
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$2.17
|
|
|
Service Code
|
NDC 68084024311
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna Medicare |
$0.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.68
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.54
|
| Rate for Payer: BCBS Trust/PPO |
$1.78
|
| Rate for Payer: BCN Commercial |
$1.78
|
| Rate for Payer: BCN Medicare Advantage |
$0.54
|
| Rate for Payer: Cash Price |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$1.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.54
|
| Rate for Payer: Healthscope Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.63
|
| Rate for Payer: Mclaren Medicaid |
$0.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.57
|
| Rate for Payer: Meridian Medicaid |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Nomi Health Commercial |
$1.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.63
|
| Rate for Payer: PACE Senior Care Partners |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.54
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: PHP Medicare Advantage |
$0.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.89
|
| Rate for Payer: Priority Health Medicare |
$0.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.51
|
| Rate for Payer: Railroad Medicare Medicare |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.91
|
| Rate for Payer: UHC Core |
$1.81
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.38
|
| Rate for Payer: UHC Medicare Advantage |
$0.54
|
| Rate for Payer: UHCCP Medicaid |
$0.38
|
| Rate for Payer: VA VA |
$0.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.63
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
OP
|
$196.65
|
|
|
Service Code
|
NDC 00904595961
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.67 |
| Max. Negotiated Rate |
$176.99 |
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: Aetna Medicare |
$51.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.45
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$49.16
|
| Rate for Payer: BCBS Trust/PPO |
$161.67
|
| Rate for Payer: BCN Commercial |
$161.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.16
|
| Rate for Payer: Cash Price |
$157.32
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.16
|
| Rate for Payer: Healthscope Commercial |
$176.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.49
|
| Rate for Payer: Mclaren Medicaid |
$34.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.62
|
| Rate for Payer: Meridian Medicaid |
$36.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.15
|
| Rate for Payer: Nomi Health Commercial |
$161.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.49
|
| Rate for Payer: PACE Senior Care Partners |
$46.70
|
| Rate for Payer: PACE SWMI |
$49.16
|
| Rate for Payer: PHP Commercial |
$167.15
|
| Rate for Payer: PHP Medicare Advantage |
$49.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.09
|
| Rate for Payer: Priority Health Medicare |
$49.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.87
|
| Rate for Payer: Railroad Medicare Medicare |
$49.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.05
|
| Rate for Payer: UHC Core |
$164.20
|
| Rate for Payer: UHC Exchange |
$49.16
|
| Rate for Payer: UHC Medicaid |
$34.67
|
| Rate for Payer: UHC Medicare Advantage |
$49.16
|
| Rate for Payer: UHCCP Medicaid |
$34.67
|
| Rate for Payer: VA VA |
$49.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.49
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$2.17
|
|
|
Service Code
|
NDC 68084024311
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.79
|
| Rate for Payer: BCN Commercial |
$1.79
|
| Rate for Payer: Cash Price |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$1.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.74
|
| Rate for Payer: Healthscope Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Nomi Health Commercial |
$1.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.63
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.91
|
| Rate for Payer: UHC Core |
$1.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.63
|
|
|
CLINDAMYCIN HCL 150 MG CAPSULE
|
Facility
|
IP
|
$196.65
|
|
|
Service Code
|
NDC 00904595961
|
| Hospital Charge Code |
1740
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.87 |
| Max. Negotiated Rate |
$176.99 |
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: BCBS Trust/PPO |
$162.41
|
| Rate for Payer: BCN Commercial |
$162.41
|
| Rate for Payer: Cash Price |
$157.32
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
| Rate for Payer: Healthscope Commercial |
$176.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.15
|
| Rate for Payer: Nomi Health Commercial |
$161.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.49
|
| Rate for Payer: PHP Commercial |
$167.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.05
|
| Rate for Payer: UHC Core |
$164.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.49
|
|
|
CLINDAMYCIN IN NS 30 MG/0.5 ML FOR DISCOGRAM
|
Facility
|
OP
|
$9.96
|
|
|
Service Code
|
NDC 09900000390
|
| Hospital Charge Code |
163511
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$8.96 |
| Rate for Payer: Aetna Commercial |
$8.47
|
| Rate for Payer: Aetna Medicare |
$2.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.11
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: BCBS MAPPO |
$2.49
|
| Rate for Payer: BCBS Trust/PPO |
$8.19
|
| Rate for Payer: BCN Commercial |
$8.19
|
| Rate for Payer: BCN Medicare Advantage |
$2.49
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.49
|
| Rate for Payer: Healthscope Commercial |
$8.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.47
|
| Rate for Payer: Mclaren Medicaid |
$1.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.61
|
| Rate for Payer: Meridian Medicaid |
$1.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.47
|
| Rate for Payer: Nomi Health Commercial |
$8.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.47
|
| Rate for Payer: PACE Senior Care Partners |
$2.37
|
| Rate for Payer: PACE SWMI |
$2.49
|
| Rate for Payer: PHP Commercial |
$8.47
|
| Rate for Payer: PHP Medicare Advantage |
$2.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.67
|
| Rate for Payer: Priority Health Medicare |
$2.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.76
|
| Rate for Payer: UHC Core |
$8.32
|
| Rate for Payer: UHC Exchange |
$2.49
|
| Rate for Payer: UHC Medicaid |
$1.76
|
| Rate for Payer: UHC Medicare Advantage |
$2.49
|
| Rate for Payer: UHCCP Medicaid |
$1.76
|
| Rate for Payer: VA VA |
$2.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.47
|
|
|
CLINDAMYCIN IN NS 30 MG/0.5 ML FOR DISCOGRAM
|
Facility
|
IP
|
$9.96
|
|
|
Service Code
|
NDC 09900000390
|
| Hospital Charge Code |
163511
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$8.96 |
| Rate for Payer: Aetna Commercial |
$8.47
|
| Rate for Payer: BCBS Trust/PPO |
$8.23
|
| Rate for Payer: BCN Commercial |
$8.23
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.97
|
| Rate for Payer: Healthscope Commercial |
$8.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.47
|
| Rate for Payer: Nomi Health Commercial |
$8.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.47
|
| Rate for Payer: PHP Commercial |
$8.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.76
|
| Rate for Payer: UHC Core |
$8.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.47
|
|
|
CLOBETASOL 0.05 % TOPICAL CREAM
|
Facility
|
OP
|
$20.86
|
|
|
Service Code
|
NDC 21922001604
|
| Hospital Charge Code |
9630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.68 |
| Max. Negotiated Rate |
$18.77 |
| Rate for Payer: Aetna Commercial |
$17.73
|
| Rate for Payer: Aetna Medicare |
$5.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.86
|
| Rate for Payer: BCBS MAPPO |
$5.21
|
| Rate for Payer: BCBS Trust/PPO |
$17.15
|
| Rate for Payer: BCN Commercial |
$17.15
|
| Rate for Payer: BCN Medicare Advantage |
$5.21
|
| Rate for Payer: Cash Price |
$16.69
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.21
|
| Rate for Payer: Healthscope Commercial |
$18.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.64
|
| Rate for Payer: Mclaren Medicaid |
$3.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$3.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.73
|
| Rate for Payer: Nomi Health Commercial |
$17.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.64
|
| Rate for Payer: PACE Senior Care Partners |
$4.95
|
| Rate for Payer: PACE SWMI |
$5.21
|
| Rate for Payer: PHP Commercial |
$17.73
|
| Rate for Payer: PHP Medicare Advantage |
$5.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.15
|
| Rate for Payer: Priority Health Medicare |
$5.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.36
|
| Rate for Payer: UHC Core |
$17.42
|
| Rate for Payer: UHC Exchange |
$5.21
|
| Rate for Payer: UHC Medicaid |
$3.68
|
| Rate for Payer: UHC Medicare Advantage |
$5.21
|
| Rate for Payer: UHCCP Medicaid |
$3.68
|
| Rate for Payer: VA VA |
$5.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.64
|
|
|
CLOBETASOL 0.05 % TOPICAL CREAM
|
Facility
|
IP
|
$20.86
|
|
|
Service Code
|
NDC 21922001604
|
| Hospital Charge Code |
9630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.52 |
| Max. Negotiated Rate |
$18.77 |
| Rate for Payer: Aetna Commercial |
$17.73
|
| Rate for Payer: BCBS Trust/PPO |
$17.23
|
| Rate for Payer: BCN Commercial |
$17.23
|
| Rate for Payer: Cash Price |
$16.69
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$18.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.73
|
| Rate for Payer: Nomi Health Commercial |
$17.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.64
|
| Rate for Payer: PHP Commercial |
$17.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.36
|
| Rate for Payer: UHC Core |
$17.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.64
|
|
|
CLONAZEPAM 0.25 MG CUSTOM TAB
|
Facility
|
IP
|
$0.65
|
|
|
Service Code
|
NDC 09900000354
|
| Hospital Charge Code |
158588
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.59 |
| Rate for Payer: Aetna Commercial |
$0.55
|
| Rate for Payer: BCBS Trust/PPO |
$0.54
|
| Rate for Payer: BCN Commercial |
$0.54
|
| Rate for Payer: Cash Price |
$0.52
|
| Rate for Payer: Cofinity Commercial |
$0.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.52
|
| Rate for Payer: Healthscope Commercial |
$0.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.55
|
| Rate for Payer: Nomi Health Commercial |
$0.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.49
|
| Rate for Payer: PHP Commercial |
$0.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.57
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.49
|
|
|
CLONAZEPAM 0.25 MG CUSTOM TAB
|
Facility
|
OP
|
$0.65
|
|
|
Service Code
|
NDC 09900000354
|
| Hospital Charge Code |
158588
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.59 |
| Rate for Payer: Aetna Commercial |
$0.55
|
| Rate for Payer: Aetna Medicare |
$0.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.20
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.53
|
| Rate for Payer: BCN Commercial |
$0.53
|
| Rate for Payer: BCN Medicare Advantage |
$0.16
|
| Rate for Payer: Cash Price |
$0.52
|
| Rate for Payer: Cofinity Commercial |
$0.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.16
|
| Rate for Payer: Healthscope Commercial |
$0.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.49
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.17
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.55
|
| Rate for Payer: Nomi Health Commercial |
$0.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.49
|
| Rate for Payer: PACE Senior Care Partners |
$0.15
|
| Rate for Payer: PACE SWMI |
$0.16
|
| Rate for Payer: PHP Commercial |
$0.55
|
| Rate for Payer: PHP Medicare Advantage |
$0.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.57
|
| Rate for Payer: Priority Health Medicare |
$0.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.45
|
| Rate for Payer: Railroad Medicare Medicare |
$0.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.57
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.16
|
| Rate for Payer: UHC Medicaid |
$0.11
|
| Rate for Payer: UHC Medicare Advantage |
$0.16
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: VA VA |
$0.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.49
|
|
|
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$247.40
|
|
|
Service Code
|
NDC 49884030702
|
| Hospital Charge Code |
35626
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.19 |
| Max. Negotiated Rate |
$222.66 |
| Rate for Payer: Aetna Commercial |
$210.29
|
| Rate for Payer: BCBS Trust/PPO |
$204.33
|
| Rate for Payer: BCN Commercial |
$204.33
|
| Rate for Payer: Cash Price |
$197.92
|
| Rate for Payer: Cofinity Commercial |
$212.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.92
|
| Rate for Payer: Healthscope Commercial |
$222.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.29
|
| Rate for Payer: Nomi Health Commercial |
$202.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.55
|
| Rate for Payer: PHP Commercial |
$210.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.71
|
| Rate for Payer: UHC Core |
$206.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.55
|
|
|
CLONAZEPAM 0.25 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$4.13
|
|
|
Service Code
|
NDC 49884030752
|
| Hospital Charge Code |
35626
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$3.72 |
| Rate for Payer: Aetna Commercial |
$3.51
|
| Rate for Payer: BCBS Trust/PPO |
$3.41
|
| Rate for Payer: BCN Commercial |
$3.41
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$3.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.51
|
| Rate for Payer: Nomi Health Commercial |
$3.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.10
|
| Rate for Payer: PHP Commercial |
$3.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.63
|
| Rate for Payer: UHC Core |
$3.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.10
|
|
