|
CLINDAMYCIN 300 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$25.16
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183288
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna American Axle |
$16.35
|
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna Medicare |
$12.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.35
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: Cash Price |
$20.13
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Cofinity Commercial |
$21.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.13
|
| Rate for Payer: Healthscope Commercial |
$22.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.35
|
| Rate for Payer: Priority Health SBD |
$15.85
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.87
|
|
|
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 |
$7.90 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UMR Bronson Commercial |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
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 |
$9.40 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Commercial |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UMR Bronson Commercial |
$9.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$32.04
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.85 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna American Axle |
$20.83
|
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
| Rate for Payer: UMR Bronson Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.03
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$44.28
|
|
|
Service Code
|
NDC 43066099324
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Aetna American Axle |
$28.78
|
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.78
|
| Rate for Payer: BCBS Complete |
$17.71
|
| Rate for Payer: Cash Price |
$35.42
|
| Rate for Payer: Cofinity Commercial |
$31.00
|
| Rate for Payer: Cofinity Commercial |
$38.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.42
|
| Rate for Payer: Healthscope Commercial |
$39.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.78
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$16.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.21
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$44.28
|
|
|
Service Code
|
NDC 43066099324
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Aetna American Axle |
$28.78
|
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.78
|
| Rate for Payer: Cash Price |
$35.42
|
| Rate for Payer: Cofinity Commercial |
$31.00
|
| Rate for Payer: Cofinity Commercial |
$38.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.42
|
| Rate for Payer: Healthscope Commercial |
$39.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.78
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$19.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.21
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$32.04
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.10 |
| Max. Negotiated Rate |
$28.84 |
| Rate for Payer: Aetna American Axle |
$20.83
|
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.83
|
| Rate for Payer: Cash Price |
$25.63
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$27.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.63
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.23
|
| Rate for Payer: PHP Commercial |
$27.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.83
|
| Rate for Payer: Priority Health SBD |
$20.19
|
| Rate for Payer: UMR Bronson Commercial |
$14.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.03
|
|
|
CLINDAMYCIN 600 MG (IV PREMIX)
|
Facility
|
IP
|
$66.10
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
500559
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna American Axle |
$42.97
|
| Rate for Payer: Aetna Commercial |
$56.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.97
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$46.27
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.19
|
| Rate for Payer: PHP Commercial |
$56.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.97
|
| Rate for Payer: Priority Health SBD |
$41.64
|
| Rate for Payer: UMR Bronson Commercial |
$29.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
CLINDAMYCIN 600 MG (IV PREMIX)
|
Facility
|
OP
|
$66.10
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
500559
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.46 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna American Axle |
$42.97
|
| Rate for Payer: Aetna Commercial |
$56.19
|
| Rate for Payer: Aetna Medicare |
$33.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.97
|
| Rate for Payer: BCBS Complete |
$26.44
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$46.27
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.19
|
| Rate for Payer: PHP Commercial |
$56.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.97
|
| Rate for Payer: Priority Health SBD |
$41.64
|
| Rate for Payer: UMR Bronson Commercial |
$24.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$385.40
|
|
|
Service Code
|
NDC 00574012901
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.58 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna American Axle |
$250.51
|
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
| Rate for Payer: UMR Bronson Commercial |
$169.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$385.40
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna American Axle |
$250.51
|
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$192.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$416.10
|
|
|
Service Code
|
NDC 65862059601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$183.08 |
| Max. Negotiated Rate |
$374.49 |
| Rate for Payer: Aetna American Axle |
$270.46
|
| Rate for Payer: Aetna Commercial |
$353.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.46
|
| Rate for Payer: Cash Price |
$332.88
|
| Rate for Payer: Cofinity Commercial |
$291.27
|
| Rate for Payer: Cofinity Commercial |
$357.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$291.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.88
|
| Rate for Payer: Healthscope Commercial |
$374.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.69
|
| Rate for Payer: PHP Commercial |
$353.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.46
|
| Rate for Payer: Priority Health SBD |
$262.14
|
| Rate for Payer: UMR Bronson Commercial |
$183.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.07
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$424.65
|
|
|
Service Code
|
NDC 65162046819
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.12 |
| Max. Negotiated Rate |
$382.19 |
| Rate for Payer: Aetna American Axle |
$276.02
|
| Rate for Payer: Aetna Commercial |
$360.95
|
| Rate for Payer: Aetna Medicare |
$212.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.02
|
| Rate for Payer: BCBS Complete |
$169.86
|
| Rate for Payer: Cash Price |
$339.72
|
| Rate for Payer: Cofinity Commercial |
$297.25
|
| Rate for Payer: Cofinity Commercial |
$365.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.72
|
| Rate for Payer: Healthscope Commercial |
$382.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.95
|
| Rate for Payer: PHP Commercial |
$360.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.02
|
| Rate for Payer: Priority Health SBD |
$267.53
|
| Rate for Payer: UMR Bronson Commercial |
$157.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.49
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$424.65
|
|
|
Service Code
|
NDC 65162046819
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.85 |
| Max. Negotiated Rate |
$382.19 |
| Rate for Payer: Aetna American Axle |
$276.02
|
| Rate for Payer: Aetna Commercial |
$360.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.02
|
| Rate for Payer: Cash Price |
$339.72
|
| Rate for Payer: Cofinity Commercial |
$297.25
|
| Rate for Payer: Cofinity Commercial |
$365.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$297.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.72
|
| Rate for Payer: Healthscope Commercial |
$382.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.95
|
| Rate for Payer: PHP Commercial |
$360.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.02
|
| Rate for Payer: Priority Health SBD |
$267.53
|
| Rate for Payer: UMR Bronson Commercial |
$186.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.49
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$365.75
|
|
|
Service Code
|
NDC 59762001601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.33 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna American Axle |
$237.74
|
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna Medicare |
$182.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.74
|
| Rate for Payer: BCBS Complete |
$146.30
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$256.02
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.74
|
| Rate for Payer: Priority Health SBD |
$230.42
|
| Rate for Payer: UMR Bronson Commercial |
$135.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.31
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$385.40
|
|
|
Service Code
|
NDC 00574012901
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna American Axle |
$250.51
|
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$192.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$385.40
|
|
|
Service Code
|
NDC 23155060351
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.58 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna American Axle |
$250.51
|
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.51
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.51
|
| Rate for Payer: Priority Health SBD |
$242.80
|
| Rate for Payer: UMR Bronson Commercial |
$169.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$365.75
|
|
|
Service Code
|
NDC 59762001601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$160.93 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna American Axle |
$237.74
|
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.74
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$256.02
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.74
|
| Rate for Payer: Priority Health SBD |
$230.42
|
| Rate for Payer: UMR Bronson Commercial |
$160.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.31
|
|
|
CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$416.10
|
|
|
Service Code
|
NDC 65862059601
|
| Hospital Charge Code |
37642
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.96 |
| Max. Negotiated Rate |
$374.49 |
| Rate for Payer: Aetna American Axle |
$270.46
|
| Rate for Payer: Aetna Commercial |
$353.69
|
| Rate for Payer: Aetna Medicare |
$208.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.46
|
| Rate for Payer: BCBS Complete |
$166.44
|
| Rate for Payer: Cash Price |
$332.88
|
| Rate for Payer: Cofinity Commercial |
$291.27
|
| Rate for Payer: Cofinity Commercial |
$357.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$291.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.88
|
| Rate for Payer: Healthscope Commercial |
$374.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.69
|
| Rate for Payer: PHP Commercial |
$353.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.46
|
| Rate for Payer: Priority Health SBD |
$262.14
|
| Rate for Payer: UMR Bronson Commercial |
$153.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.07
|
|
|
CLINDAMYCIN 900 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
183290
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UMR Bronson Commercial |
$9.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
|
|
CLINDAMYCIN 900 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$26.48
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
183290
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UMR Bronson Commercial |
$11.65
|
| 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 J0737
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UMR Bronson Commercial |
$11.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$54.07
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.01 |
| Max. Negotiated Rate |
$48.66 |
| Rate for Payer: Aetna American Axle |
$35.15
|
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna American Axle |
$25.45
|
| Rate for Payer: Aetna Commercial |
$45.96
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Aetna Medicare |
$19.58
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS Complete |
$21.63
|
| Rate for Payer: Cash Price |
$43.26
|
| Rate for Payer: Cash Price |
$31.33
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$33.68
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Commercial |
$46.50
|
| Rate for Payer: Cofinity Commercial |
$37.85
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.26
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$35.24
|
| Rate for Payer: Healthscope Commercial |
$48.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.96
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$24.67
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UMR Bronson Commercial |
$20.01
|
| Rate for Payer: UMR Bronson Commercial |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
|
|
CLINDAMYCIN 900 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$26.48
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
300022
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UMR Bronson Commercial |
$9.80
|
| 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 |
$11.65 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna American Axle |
$17.21
|
| Rate for Payer: Aetna American Axle |
$25.45
|
| Rate for Payer: Aetna American Axle |
$35.15
|
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Commercial |
$22.51
|
| Rate for Payer: Aetna Commercial |
$45.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.45
|
| Rate for Payer: Cash Price |
$43.26
|
| Rate for Payer: Cash Price |
$31.33
|
| Rate for Payer: Cash Price |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$22.77
|
| Rate for Payer: Cofinity Commercial |
$33.68
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Cofinity Commercial |
$46.50
|
| Rate for Payer: Cofinity Commercial |
$37.85
|
| Rate for Payer: Cofinity Commercial |
$18.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$35.24
|
| Rate for Payer: Healthscope Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$48.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$45.96
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: PHP Commercial |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.21
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: Priority Health SBD |
$24.67
|
| Rate for Payer: Priority Health SBD |
$16.68
|
| Rate for Payer: UMR Bronson Commercial |
$11.65
|
| Rate for Payer: UMR Bronson Commercial |
$23.79
|
| Rate for Payer: UMR Bronson Commercial |
$17.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.37
|
|
