|
EMPTY CONTAINER BOTTLE
|
Facility
|
OP
|
$45.41
|
|
|
Service Code
|
NDC 85412046162
|
| Hospital Charge Code |
113131
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.16 |
| Max. Negotiated Rate |
$45.41 |
| Rate for Payer: Aetna Commercial |
$40.87
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: ASR ASR |
$44.05
|
| Rate for Payer: ASR Commercial |
$44.05
|
| Rate for Payer: BCBS Complete |
$18.16
|
| Rate for Payer: BCBS Trust/PPO |
$37.19
|
| Rate for Payer: BCN Commercial |
$35.21
|
| Rate for Payer: Cash Price |
$36.33
|
| Rate for Payer: Cofinity Commercial |
$42.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.33
|
| Rate for Payer: Healthscope Commercial |
$45.41
|
| Rate for Payer: Healthscope Whirlpool |
$44.05
|
| Rate for Payer: Mclaren Commercial |
$40.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.60
|
| Rate for Payer: Nomi Health Commercial |
$37.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.79
|
| Rate for Payer: Priority Health Narrow Network |
$31.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.96
|
|
|
EMPTY CONTAINER BOTTLE
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
NDC 00264975706
|
| Hospital Charge Code |
113131
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.79
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
OP
|
$87.84
|
|
|
Service Code
|
NDC 42385095330
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$87.84 |
| Rate for Payer: Aetna Commercial |
$79.06
|
| Rate for Payer: Aetna Medicare |
$43.92
|
| Rate for Payer: ASR ASR |
$85.20
|
| Rate for Payer: ASR Commercial |
$85.20
|
| Rate for Payer: BCBS Complete |
$35.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.93
|
| Rate for Payer: BCN Commercial |
$68.10
|
| Rate for Payer: Cash Price |
$70.27
|
| Rate for Payer: Cofinity Commercial |
$82.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.27
|
| Rate for Payer: Healthscope Commercial |
$87.84
|
| Rate for Payer: Healthscope Whirlpool |
$85.20
|
| Rate for Payer: Mclaren Commercial |
$79.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.66
|
| Rate for Payer: Nomi Health Commercial |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.97
|
| Rate for Payer: Priority Health Narrow Network |
$61.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.30
|
|
|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
IP
|
$6,646.01
|
|
|
Service Code
|
NDC 61958070101
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,319.91 |
| Max. Negotiated Rate |
$6,646.01 |
| Rate for Payer: Aetna Commercial |
$5,981.41
|
| Rate for Payer: ASR ASR |
$6,446.63
|
| Rate for Payer: ASR Commercial |
$6,446.63
|
| Rate for Payer: BCBS Trust/PPO |
$5,415.83
|
| Rate for Payer: BCN Commercial |
$5,152.65
|
| Rate for Payer: Cash Price |
$5,316.81
|
| Rate for Payer: Cofinity Commercial |
$6,247.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,316.81
|
| Rate for Payer: Healthscope Commercial |
$6,646.01
|
| Rate for Payer: Healthscope Whirlpool |
$6,446.63
|
| Rate for Payer: Mclaren Commercial |
$5,981.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,649.11
|
| Rate for Payer: Nomi Health Commercial |
$5,449.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,319.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,848.49
|
|
|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
OP
|
$6,646.01
|
|
|
Service Code
|
NDC 61958070101
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,658.40 |
| Max. Negotiated Rate |
$6,646.01 |
| Rate for Payer: Aetna Commercial |
$5,981.41
|
| Rate for Payer: Aetna Medicare |
$3,323.01
|
| Rate for Payer: ASR ASR |
$6,446.63
|
| Rate for Payer: ASR Commercial |
$6,446.63
|
| Rate for Payer: BCBS Complete |
$2,658.40
|
| Rate for Payer: BCBS Trust/PPO |
$5,442.42
|
| Rate for Payer: BCN Commercial |
$5,152.65
|
| Rate for Payer: Cash Price |
$5,316.81
|
| Rate for Payer: Cofinity Commercial |
$6,247.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,316.81
|
| Rate for Payer: Healthscope Commercial |
$6,646.01
|
| Rate for Payer: Healthscope Whirlpool |
$6,446.63
|
| Rate for Payer: Mclaren Commercial |
$5,981.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,649.11
|
| Rate for Payer: Nomi Health Commercial |
$5,449.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,319.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,823.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,658.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,848.49
|
|
|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
IP
|
$87.84
|
|
|
Service Code
|
NDC 42385095330
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.10 |
| Max. Negotiated Rate |
$87.84 |
| Rate for Payer: Aetna Commercial |
$79.06
|
| Rate for Payer: ASR ASR |
$85.20
|
| Rate for Payer: ASR Commercial |
$85.20
|
| Rate for Payer: BCBS Trust/PPO |
$71.58
|
| Rate for Payer: BCN Commercial |
$68.10
|
| Rate for Payer: Cash Price |
$70.27
|
| Rate for Payer: Cofinity Commercial |
$82.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.27
|
| Rate for Payer: Healthscope Commercial |
$87.84
|
| Rate for Payer: Healthscope Whirlpool |
$85.20
|
| Rate for Payer: Mclaren Commercial |
$79.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.66
|
| Rate for Payer: Nomi Health Commercial |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.30
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$52.13
|
|
|
Service Code
|
NDC 43598016911
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.85 |
| Max. Negotiated Rate |
$52.13 |
| Rate for Payer: Aetna Commercial |
$46.92
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: ASR ASR |
$50.57
|
| Rate for Payer: ASR Commercial |
$50.57
|
| Rate for Payer: BCBS Complete |
$20.85
|
| Rate for Payer: BCBS Trust/PPO |
$42.69
|
| Rate for Payer: BCN Commercial |
$40.42
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$52.13
|
| Rate for Payer: Healthscope Whirlpool |
$50.57
|
| Rate for Payer: Mclaren Commercial |
$46.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.31
|
| Rate for Payer: Nomi Health Commercial |
$42.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.68
|
| Rate for Payer: Priority Health Narrow Network |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.87
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$58.74
|
|
|
Service Code
|
NDC 00143978601
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$52.87
|
| Rate for Payer: Aetna Medicare |
$29.37
|
| Rate for Payer: ASR ASR |
$56.98
|
| Rate for Payer: ASR Commercial |
$56.98
|
| Rate for Payer: BCBS Complete |
$23.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.10
|
| Rate for Payer: BCN Commercial |
$45.54
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cofinity Commercial |
$55.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Healthscope Whirlpool |
$56.98
|
| Rate for Payer: Mclaren Commercial |
$52.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Nomi Health Commercial |
$48.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Narrow Network |
$41.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.69
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$58.74
|
|
|
Service Code
|
NDC 00143978610
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$52.87
|
| Rate for Payer: Aetna Medicare |
$29.37
|
| Rate for Payer: ASR ASR |
$56.98
|
| Rate for Payer: ASR Commercial |
$56.98
|
| Rate for Payer: BCBS Complete |
$23.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.10
|
| Rate for Payer: BCN Commercial |
$45.54
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cofinity Commercial |
$55.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Healthscope Whirlpool |
$56.98
|
| Rate for Payer: Mclaren Commercial |
$52.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Nomi Health Commercial |
$48.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Narrow Network |
$41.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.69
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$52.13
|
|
|
Service Code
|
NDC 43598016911
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$52.13 |
| Rate for Payer: Aetna Commercial |
$46.92
|
| Rate for Payer: ASR ASR |
$50.57
|
| Rate for Payer: ASR Commercial |
$50.57
|
| Rate for Payer: BCBS Trust/PPO |
$42.48
|
| Rate for Payer: BCN Commercial |
$40.42
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$52.13
|
| Rate for Payer: Healthscope Whirlpool |
$50.57
|
| Rate for Payer: Mclaren Commercial |
$46.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.31
|
| Rate for Payer: Nomi Health Commercial |
$42.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.87
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$58.74
|
|
|
Service Code
|
NDC 00143978610
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$52.87
|
| Rate for Payer: ASR ASR |
$56.98
|
| Rate for Payer: ASR Commercial |
$56.98
|
| Rate for Payer: BCBS Trust/PPO |
$47.87
|
| Rate for Payer: BCN Commercial |
$45.54
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cofinity Commercial |
$55.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Healthscope Whirlpool |
$56.98
|
| Rate for Payer: Mclaren Commercial |
$52.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Nomi Health Commercial |
$48.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.69
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$52.13
|
|
|
Service Code
|
NDC 43598016958
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$52.13 |
| Rate for Payer: Aetna Commercial |
$46.92
|
| Rate for Payer: ASR ASR |
$50.57
|
| Rate for Payer: ASR Commercial |
$50.57
|
| Rate for Payer: BCBS Trust/PPO |
$42.48
|
| Rate for Payer: BCN Commercial |
$40.42
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$52.13
|
| Rate for Payer: Healthscope Whirlpool |
$50.57
|
| Rate for Payer: Mclaren Commercial |
$46.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.31
|
| Rate for Payer: Nomi Health Commercial |
$42.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.87
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$52.13
|
|
|
Service Code
|
NDC 43598016958
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.85 |
| Max. Negotiated Rate |
$52.13 |
| Rate for Payer: Aetna Commercial |
$46.92
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: ASR ASR |
$50.57
|
| Rate for Payer: ASR Commercial |
$50.57
|
| Rate for Payer: BCBS Complete |
$20.85
|
| Rate for Payer: BCBS Trust/PPO |
$42.69
|
| Rate for Payer: BCN Commercial |
$40.42
|
| Rate for Payer: Cash Price |
$41.70
|
| Rate for Payer: Cofinity Commercial |
$49.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$52.13
|
| Rate for Payer: Healthscope Whirlpool |
$50.57
|
| Rate for Payer: Mclaren Commercial |
$46.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.31
|
| Rate for Payer: Nomi Health Commercial |
$42.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.68
|
| Rate for Payer: Priority Health Narrow Network |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.87
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$58.74
|
|
|
Service Code
|
NDC 00143978601
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$58.74 |
| Rate for Payer: Aetna Commercial |
$52.87
|
| Rate for Payer: ASR ASR |
$56.98
|
| Rate for Payer: ASR Commercial |
$56.98
|
| Rate for Payer: BCBS Trust/PPO |
$47.87
|
| Rate for Payer: BCN Commercial |
$45.54
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cofinity Commercial |
$55.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Healthscope Commercial |
$58.74
|
| Rate for Payer: Healthscope Whirlpool |
$56.98
|
| Rate for Payer: Mclaren Commercial |
$52.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Nomi Health Commercial |
$48.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.69
|
|
|
ENALAPRIL MALEATE 10 MG TABLET
|
Facility
|
OP
|
$442.70
|
|
|
Service Code
|
NDC 00904561061
|
| Hospital Charge Code |
9924
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.08 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: Aetna Medicare |
$221.35
|
| Rate for Payer: ASR ASR |
$429.42
|
| Rate for Payer: ASR Commercial |
$429.42
|
| Rate for Payer: BCBS Complete |
$177.08
|
| Rate for Payer: BCBS Trust/PPO |
$362.53
|
| Rate for Payer: BCN Commercial |
$343.23
|
| Rate for Payer: Cash Price |
$354.16
|
| Rate for Payer: Cofinity Commercial |
$416.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$442.70
|
| Rate for Payer: Healthscope Whirlpool |
$429.42
|
| Rate for Payer: Mclaren Commercial |
$398.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.30
|
| Rate for Payer: Nomi Health Commercial |
$363.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.89
|
| Rate for Payer: Priority Health Narrow Network |
$310.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$389.58
|
|
|
ENALAPRIL MALEATE 10 MG TABLET
|
Facility
|
IP
|
$442.70
|
|
|
Service Code
|
NDC 00904561061
|
| Hospital Charge Code |
9924
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.75 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: ASR ASR |
$429.42
|
| Rate for Payer: ASR Commercial |
$429.42
|
| Rate for Payer: BCBS Trust/PPO |
$360.76
|
| Rate for Payer: BCN Commercial |
$343.23
|
| Rate for Payer: Cash Price |
$354.16
|
| Rate for Payer: Cofinity Commercial |
$416.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$442.70
|
| Rate for Payer: Healthscope Whirlpool |
$429.42
|
| Rate for Payer: Mclaren Commercial |
$398.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.30
|
| Rate for Payer: Nomi Health Commercial |
$363.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$389.58
|
|
|
ENALAPRIL MALEATE 5 MG TABLET
|
Facility
|
IP
|
$42.18
|
|
|
Service Code
|
NDC 00904550261
|
| Hospital Charge Code |
9927
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.42 |
| Max. Negotiated Rate |
$42.18 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: ASR ASR |
$40.91
|
| Rate for Payer: ASR Commercial |
$40.91
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$32.70
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$39.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Healthscope Commercial |
$42.18
|
| Rate for Payer: Healthscope Whirlpool |
$40.91
|
| Rate for Payer: Mclaren Commercial |
$37.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.85
|
| Rate for Payer: Nomi Health Commercial |
$34.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.12
|
|
|
ENALAPRIL MALEATE 5 MG TABLET
|
Facility
|
OP
|
$42.18
|
|
|
Service Code
|
NDC 00904550261
|
| Hospital Charge Code |
9927
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$42.18 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: ASR ASR |
$40.91
|
| Rate for Payer: ASR Commercial |
$40.91
|
| Rate for Payer: BCBS Complete |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$34.54
|
| Rate for Payer: BCN Commercial |
$32.70
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$39.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Healthscope Commercial |
$42.18
|
| Rate for Payer: Healthscope Whirlpool |
$40.91
|
| Rate for Payer: Mclaren Commercial |
$37.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.85
|
| Rate for Payer: Nomi Health Commercial |
$34.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.96
|
| Rate for Payer: Priority Health Narrow Network |
$29.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.12
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$32.75
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$32.75 |
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Commercial |
$79.60
|
| Rate for Payer: Aetna Commercial |
$96.98
|
| Rate for Payer: Aetna Commercial |
$55.87
|
| Rate for Payer: Aetna Medicare |
$44.22
|
| Rate for Payer: Aetna Medicare |
$16.38
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna Medicare |
$53.88
|
| Rate for Payer: ASR ASR |
$60.22
|
| Rate for Payer: ASR ASR |
$104.53
|
| Rate for Payer: ASR ASR |
$85.79
|
| Rate for Payer: ASR ASR |
$31.77
|
| Rate for Payer: ASR Commercial |
$31.77
|
| Rate for Payer: ASR Commercial |
$60.22
|
| Rate for Payer: ASR Commercial |
$85.79
|
| Rate for Payer: ASR Commercial |
$104.53
|
| Rate for Payer: BCBS Complete |
$43.10
|
| Rate for Payer: BCBS Complete |
$35.38
|
| Rate for Payer: BCBS Complete |
$24.83
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$26.82
|
| Rate for Payer: BCBS Trust/PPO |
$72.42
|
| Rate for Payer: BCBS Trust/PPO |
$88.24
|
| Rate for Payer: BCBS Trust/PPO |
$50.84
|
| Rate for Payer: BCN Commercial |
$68.57
|
| Rate for Payer: BCN Commercial |
$25.39
|
| Rate for Payer: BCN Commercial |
$83.55
|
| Rate for Payer: BCN Commercial |
$48.13
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$70.75
|
| Rate for Payer: Cofinity Commercial |
$101.29
|
| Rate for Payer: Cofinity Commercial |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$58.36
|
| Rate for Payer: Cofinity Commercial |
$83.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Healthscope Commercial |
$107.76
|
| Rate for Payer: Healthscope Commercial |
$32.75
|
| Rate for Payer: Healthscope Commercial |
$88.44
|
| Rate for Payer: Healthscope Whirlpool |
$85.79
|
| Rate for Payer: Healthscope Whirlpool |
$60.22
|
| Rate for Payer: Healthscope Whirlpool |
$31.77
|
| Rate for Payer: Healthscope Whirlpool |
$104.53
|
| Rate for Payer: Mclaren Commercial |
$96.98
|
| Rate for Payer: Mclaren Commercial |
$29.48
|
| Rate for Payer: Mclaren Commercial |
$55.87
|
| Rate for Payer: Mclaren Commercial |
$79.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Nomi Health Commercial |
$50.91
|
| Rate for Payer: Nomi Health Commercial |
$26.86
|
| Rate for Payer: Nomi Health Commercial |
$72.52
|
| Rate for Payer: Nomi Health Commercial |
$88.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.42
|
| Rate for Payer: Priority Health Narrow Network |
$43.52
|
| Rate for Payer: Priority Health Narrow Network |
$22.96
|
| Rate for Payer: Priority Health Narrow Network |
$62.00
|
| Rate for Payer: Priority Health Narrow Network |
$75.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.82
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$62.08
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.35 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$55.87
|
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Commercial |
$79.60
|
| Rate for Payer: Aetna Commercial |
$96.98
|
| Rate for Payer: ASR ASR |
$104.53
|
| Rate for Payer: ASR ASR |
$60.22
|
| Rate for Payer: ASR ASR |
$31.77
|
| Rate for Payer: ASR ASR |
$85.79
|
| Rate for Payer: ASR Commercial |
$60.22
|
| Rate for Payer: ASR Commercial |
$85.79
|
| Rate for Payer: ASR Commercial |
$31.77
|
| Rate for Payer: ASR Commercial |
$104.53
|
| Rate for Payer: BCBS Trust/PPO |
$72.07
|
| Rate for Payer: BCBS Trust/PPO |
$87.81
|
| Rate for Payer: BCBS Trust/PPO |
$26.69
|
| Rate for Payer: BCBS Trust/PPO |
$50.59
|
| Rate for Payer: BCN Commercial |
$68.57
|
| Rate for Payer: BCN Commercial |
$83.55
|
| Rate for Payer: BCN Commercial |
$48.13
|
| Rate for Payer: BCN Commercial |
$25.39
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$70.75
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cofinity Commercial |
$58.36
|
| Rate for Payer: Cofinity Commercial |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$83.13
|
| Rate for Payer: Cofinity Commercial |
$101.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Healthscope Commercial |
$32.75
|
| Rate for Payer: Healthscope Commercial |
$107.76
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Healthscope Commercial |
$88.44
|
| Rate for Payer: Healthscope Whirlpool |
$85.79
|
| Rate for Payer: Healthscope Whirlpool |
$31.77
|
| Rate for Payer: Healthscope Whirlpool |
$60.22
|
| Rate for Payer: Healthscope Whirlpool |
$104.53
|
| Rate for Payer: Mclaren Commercial |
$55.87
|
| Rate for Payer: Mclaren Commercial |
$79.60
|
| Rate for Payer: Mclaren Commercial |
$29.48
|
| Rate for Payer: Mclaren Commercial |
$96.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Nomi Health Commercial |
$88.36
|
| Rate for Payer: Nomi Health Commercial |
$72.52
|
| Rate for Payer: Nomi Health Commercial |
$50.91
|
| Rate for Payer: Nomi Health Commercial |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.83
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$39.25
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna Commercial |
$35.33
|
| Rate for Payer: ASR ASR |
$38.07
|
| Rate for Payer: ASR Commercial |
$38.07
|
| Rate for Payer: BCBS Trust/PPO |
$31.98
|
| Rate for Payer: BCN Commercial |
$30.43
|
| Rate for Payer: Cash Price |
$31.40
|
| Rate for Payer: Cofinity Commercial |
$36.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.40
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Healthscope Whirlpool |
$38.07
|
| Rate for Payer: Mclaren Commercial |
$35.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.36
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.54
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$39.25
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.70 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna Commercial |
$35.33
|
| Rate for Payer: Aetna Medicare |
$19.62
|
| Rate for Payer: ASR ASR |
$38.07
|
| Rate for Payer: ASR Commercial |
$38.07
|
| Rate for Payer: BCBS Complete |
$15.70
|
| Rate for Payer: BCBS Trust/PPO |
$32.14
|
| Rate for Payer: BCN Commercial |
$30.43
|
| Rate for Payer: Cash Price |
$31.40
|
| Rate for Payer: Cofinity Commercial |
$36.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.40
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Healthscope Whirlpool |
$38.07
|
| Rate for Payer: Mclaren Commercial |
$35.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.36
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.39
|
| Rate for Payer: Priority Health Narrow Network |
$27.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.54
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$18.48
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$18.48 |
| Rate for Payer: Aetna Commercial |
$16.63
|
| Rate for Payer: Aetna Commercial |
$14.51
|
| Rate for Payer: Aetna Commercial |
$29.06
|
| Rate for Payer: Aetna Commercial |
$14.12
|
| Rate for Payer: ASR ASR |
$15.22
|
| Rate for Payer: ASR ASR |
$17.93
|
| Rate for Payer: ASR ASR |
$15.64
|
| Rate for Payer: ASR ASR |
$31.32
|
| Rate for Payer: ASR Commercial |
$17.93
|
| Rate for Payer: ASR Commercial |
$31.32
|
| Rate for Payer: ASR Commercial |
$15.64
|
| Rate for Payer: ASR Commercial |
$15.22
|
| Rate for Payer: BCBS Trust/PPO |
$26.31
|
| Rate for Payer: BCBS Trust/PPO |
$12.79
|
| Rate for Payer: BCBS Trust/PPO |
$13.14
|
| Rate for Payer: BCBS Trust/PPO |
$15.06
|
| Rate for Payer: BCN Commercial |
$25.03
|
| Rate for Payer: BCN Commercial |
$12.16
|
| Rate for Payer: BCN Commercial |
$14.33
|
| Rate for Payer: BCN Commercial |
$12.50
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$15.69
|
| Rate for Payer: Healthscope Commercial |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$31.32
|
| Rate for Payer: Healthscope Whirlpool |
$15.64
|
| Rate for Payer: Healthscope Whirlpool |
$17.93
|
| Rate for Payer: Healthscope Whirlpool |
$15.22
|
| Rate for Payer: Mclaren Commercial |
$16.63
|
| Rate for Payer: Mclaren Commercial |
$29.06
|
| Rate for Payer: Mclaren Commercial |
$14.51
|
| Rate for Payer: Mclaren Commercial |
$14.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Nomi Health Commercial |
$15.15
|
| Rate for Payer: Nomi Health Commercial |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.81
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$16.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$16.12 |
| Rate for Payer: Aetna Commercial |
$14.51
|
| Rate for Payer: Aetna Commercial |
$29.06
|
| Rate for Payer: Aetna Commercial |
$14.12
|
| Rate for Payer: Aetna Commercial |
$16.63
|
| Rate for Payer: Aetna Medicare |
$16.14
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Aetna Medicare |
$9.24
|
| Rate for Payer: Aetna Medicare |
$7.84
|
| Rate for Payer: ASR ASR |
$17.93
|
| Rate for Payer: ASR ASR |
$15.22
|
| Rate for Payer: ASR ASR |
$31.32
|
| Rate for Payer: ASR ASR |
$15.64
|
| Rate for Payer: ASR Commercial |
$15.64
|
| Rate for Payer: ASR Commercial |
$17.93
|
| Rate for Payer: ASR Commercial |
$31.32
|
| Rate for Payer: ASR Commercial |
$15.22
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS Complete |
$12.92
|
| Rate for Payer: BCBS Complete |
$7.39
|
| Rate for Payer: BCBS Complete |
$6.45
|
| Rate for Payer: BCBS Trust/PPO |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$26.44
|
| Rate for Payer: BCBS Trust/PPO |
$12.85
|
| Rate for Payer: BCBS Trust/PPO |
$15.13
|
| Rate for Payer: BCN Commercial |
$25.03
|
| Rate for Payer: BCN Commercial |
$12.50
|
| Rate for Payer: BCN Commercial |
$12.16
|
| Rate for Payer: BCN Commercial |
$14.33
|
| Rate for Payer: Cash Price |
$12.90
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$15.69
|
| Rate for Payer: Healthscope Commercial |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$31.32
|
| Rate for Payer: Healthscope Whirlpool |
$17.93
|
| Rate for Payer: Healthscope Whirlpool |
$15.64
|
| Rate for Payer: Healthscope Whirlpool |
$15.22
|
| Rate for Payer: Mclaren Commercial |
$14.12
|
| Rate for Payer: Mclaren Commercial |
$14.51
|
| Rate for Payer: Mclaren Commercial |
$16.63
|
| Rate for Payer: Mclaren Commercial |
$29.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.71
|
| Rate for Payer: Nomi Health Commercial |
$15.15
|
| Rate for Payer: Nomi Health Commercial |
$13.22
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.75
|
| Rate for Payer: Priority Health Narrow Network |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$11.30
|
| Rate for Payer: Priority Health Narrow Network |
$22.64
|
| Rate for Payer: Priority Health Narrow Network |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.19
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$19.80
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.87 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$16.42
|
| Rate for Payer: Aetna Commercial |
$18.40
|
| Rate for Payer: ASR ASR |
$17.69
|
| Rate for Payer: ASR ASR |
$19.21
|
| Rate for Payer: ASR ASR |
$19.83
|
| Rate for Payer: ASR Commercial |
$19.21
|
| Rate for Payer: ASR Commercial |
$17.69
|
| Rate for Payer: ASR Commercial |
$19.83
|
| Rate for Payer: BCBS Trust/PPO |
$16.66
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCBS Trust/PPO |
$16.14
|
| Rate for Payer: BCN Commercial |
$14.14
|
| Rate for Payer: BCN Commercial |
$15.85
|
| Rate for Payer: BCN Commercial |
$15.35
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cash Price |
$16.35
|
| Rate for Payer: Cofinity Commercial |
$19.21
|
| Rate for Payer: Cofinity Commercial |
$17.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.35
|
| Rate for Payer: Healthscope Commercial |
$18.24
|
| Rate for Payer: Healthscope Commercial |
$19.80
|
| Rate for Payer: Healthscope Commercial |
$20.44
|
| Rate for Payer: Healthscope Whirlpool |
$19.21
|
| Rate for Payer: Healthscope Whirlpool |
$17.69
|
| Rate for Payer: Healthscope Whirlpool |
$19.83
|
| Rate for Payer: Mclaren Commercial |
$17.82
|
| Rate for Payer: Mclaren Commercial |
$16.42
|
| Rate for Payer: Mclaren Commercial |
$18.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$16.24
|
| Rate for Payer: Nomi Health Commercial |
$14.96
|
| Rate for Payer: Nomi Health Commercial |
$16.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.05
|
|
