|
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION
|
Facility
IP
|
$23.38
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9488
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.37 |
| Max. Negotiated Rate |
$23.38 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Commercial |
$14.98
|
| Rate for Payer: Aetna Commercial |
$41.32
|
| Rate for Payer: ASR ASR |
$44.53
|
| Rate for Payer: ASR ASR |
$16.15
|
| Rate for Payer: ASR ASR |
$22.68
|
| Rate for Payer: BCBS Trust/PPO |
$18.13
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$18.13
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.73
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$15.65
|
| Rate for Payer: Cofinity Commercial |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$43.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.70
|
| Rate for Payer: Healthscope Commercial |
$23.38
|
| Rate for Payer: Healthscope Commercial |
$45.91
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Healthscope Whirlpool |
$22.68
|
| Rate for Payer: Healthscope Whirlpool |
$16.15
|
| Rate for Payer: Healthscope Whirlpool |
$44.53
|
| Rate for Payer: Mclaren Commercial |
$14.98
|
| Rate for Payer: Mclaren Commercial |
$21.04
|
| Rate for Payer: Mclaren Commercial |
$41.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.57
|
|
|
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION
|
Facility
IP
|
$9.54
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9490
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$9.54 |
| Rate for Payer: Aetna Commercial |
$8.59
|
| Rate for Payer: Aetna Commercial |
$10.77
|
| Rate for Payer: Aetna Commercial |
$2.77
|
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: ASR ASR |
$2.94
|
| Rate for Payer: ASR ASR |
$11.61
|
| Rate for Payer: ASR ASR |
$2.99
|
| Rate for Payer: ASR ASR |
$9.25
|
| Rate for Payer: BCBS Trust/PPO |
$2.35
|
| Rate for Payer: BCBS Trust/PPO |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$9.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.39
|
| Rate for Payer: BCN Commercial |
$2.35
|
| Rate for Payer: BCN Commercial |
$9.28
|
| Rate for Payer: BCN Commercial |
$7.40
|
| Rate for Payer: BCN Commercial |
$2.39
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$7.63
|
| Rate for Payer: Cash Price |
$9.58
|
| Rate for Payer: Cash Price |
$2.47
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Cofinity Commercial |
$11.25
|
| Rate for Payer: Cofinity Commercial |
$2.85
|
| Rate for Payer: Cofinity Commercial |
$2.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.58
|
| Rate for Payer: Healthscope Commercial |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$9.54
|
| Rate for Payer: Healthscope Commercial |
$3.08
|
| Rate for Payer: Healthscope Commercial |
$3.03
|
| Rate for Payer: Healthscope Whirlpool |
$2.94
|
| Rate for Payer: Healthscope Whirlpool |
$11.61
|
| Rate for Payer: Healthscope Whirlpool |
$2.99
|
| Rate for Payer: Healthscope Whirlpool |
$9.25
|
| Rate for Payer: Mclaren Commercial |
$2.73
|
| Rate for Payer: Mclaren Commercial |
$2.77
|
| Rate for Payer: Mclaren Commercial |
$8.59
|
| Rate for Payer: Mclaren Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.40
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
IP
|
$356.16
|
|
|
Service Code
|
NDC 0904-6502-61
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$249.31 |
| Max. Negotiated Rate |
$356.16 |
| Rate for Payer: Aetna Commercial |
$320.54
|
| Rate for Payer: ASR ASR |
$345.48
|
| Rate for Payer: BCBS Trust/PPO |
$276.13
|
| Rate for Payer: BCN Commercial |
$276.13
|
| Rate for Payer: Cash Price |
$284.93
|
| Rate for Payer: Cofinity Commercial |
$334.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.93
|
| Rate for Payer: Healthscope Commercial |
$356.16
|
| Rate for Payer: Healthscope Whirlpool |
$345.48
|
| Rate for Payer: Mclaren Commercial |
$320.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.42
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
IP
|
$270.25
|
|
|
Service Code
|
NDC 69097-422-07
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$189.18 |
| Max. Negotiated Rate |
$270.25 |
| Rate for Payer: Aetna Commercial |
$243.22
|
| Rate for Payer: ASR ASR |
$262.14
|
| Rate for Payer: BCBS Trust/PPO |
$209.52
|
| Rate for Payer: BCN Commercial |
$209.52
|
| Rate for Payer: Cash Price |
$216.20
|
| Rate for Payer: Cofinity Commercial |
$254.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.20
|
| Rate for Payer: Healthscope Commercial |
$270.25
|
| Rate for Payer: Healthscope Whirlpool |
$262.14
|
| Rate for Payer: Mclaren Commercial |
$243.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.82
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
IP
|
$328.00
|
|
|
Service Code
|
NDC 0025-1520-34
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: Aetna Commercial |
$295.20
|
| Rate for Payer: ASR ASR |
$318.16
|
| Rate for Payer: BCBS Trust/PPO |
$254.30
|
| Rate for Payer: BCN Commercial |
$254.30
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$308.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Healthscope Commercial |
$328.00
|
| Rate for Payer: Healthscope Whirlpool |
$318.16
|
| Rate for Payer: Mclaren Commercial |
$295.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$278.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.64
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
IP
|
$3,280.05
|
|
|
Service Code
|
NDC 0025-1520-31
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,296.04 |
| Max. Negotiated Rate |
$3,280.05 |
| Rate for Payer: Aetna Commercial |
$2,952.04
|
| Rate for Payer: ASR ASR |
$3,181.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,543.02
|
| Rate for Payer: BCN Commercial |
$2,543.02
|
| Rate for Payer: Cash Price |
$2,624.04
|
| Rate for Payer: Cofinity Commercial |
$3,083.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,624.04
|
| Rate for Payer: Healthscope Commercial |
$3,280.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,181.65
|
| Rate for Payer: Mclaren Commercial |
$2,952.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,788.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,296.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,886.44
|
|
|
CELLULITIS WITH MCC
|
Facility
IP
|
$19,099.50
|
|
|
Service Code
|
MS-DRG 602
|
| Min. Negotiated Rate |
$13,560.96 |
| Max. Negotiated Rate |
$19,099.50 |
| Rate for Payer: Aetna Medicare |
$14,274.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,843.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,843.38
|
| Rate for Payer: BCBS MAPPO |
$14,274.70
|
| Rate for Payer: BCN Medicare Advantage |
$14,274.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,274.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,274.70
|
| Rate for Payer: Mclaren Medicare |
$14,274.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,988.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,415.90
|
| Rate for Payer: PACE Medicare |
$13,560.96
|
| Rate for Payer: PACE SWMI |
$14,274.70
|
| Rate for Payer: PHP Commercial |
$15,702.17
|
| Rate for Payer: PHP Medicare Advantage |
$14,274.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,099.50
|
| Rate for Payer: Priority Health Medicare |
$14,274.70
|
| Rate for Payer: Priority Health Narrow Network |
$15,279.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14,274.70
|
| Rate for Payer: UHC Medicare Advantage |
$14,702.94
|
| Rate for Payer: VA VA |
$14,274.70
|
|
|
CELLULITIS WITHOUT MCC
|
Facility
IP
|
$11,463.95
|
|
|
Service Code
|
MS-DRG 603
|
| Min. Negotiated Rate |
$8,712.60 |
| Max. Negotiated Rate |
$11,463.95 |
| Rate for Payer: Aetna Medicare |
$9,171.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,463.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,463.95
|
| Rate for Payer: BCBS MAPPO |
$9,171.16
|
| Rate for Payer: BCN Medicare Advantage |
$9,171.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,171.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,171.16
|
| Rate for Payer: Mclaren Medicare |
$9,171.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,629.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,546.83
|
| Rate for Payer: PACE Medicare |
$8,712.60
|
| Rate for Payer: PACE SWMI |
$9,171.16
|
| Rate for Payer: PHP Commercial |
$10,088.28
|
| Rate for Payer: PHP Medicare Advantage |
$9,171.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,359.55
|
| Rate for Payer: Priority Health Medicare |
$9,171.16
|
| Rate for Payer: Priority Health Narrow Network |
$9,087.64
|
| Rate for Payer: Railroad Medicare Medicare |
$9,171.16
|
| Rate for Payer: UHC Medicare Advantage |
$9,446.29
|
| Rate for Payer: VA VA |
$9,171.16
|
|
|
CELLULOSE, OXIDIZED 4" X 8" PADS
|
Facility
IP
|
$273.05
|
|
|
Service Code
|
NDC 0990-0006-04
|
| Hospital Charge Code |
169204
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$273.05 |
| Rate for Payer: Aetna Commercial |
$245.74
|
| Rate for Payer: ASR ASR |
$264.86
|
| Rate for Payer: BCBS Trust/PPO |
$211.70
|
| Rate for Payer: BCN Commercial |
$211.70
|
| Rate for Payer: Cash Price |
$218.44
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.44
|
| Rate for Payer: Healthscope Commercial |
$273.05
|
| Rate for Payer: Healthscope Whirlpool |
$264.86
|
| Rate for Payer: Mclaren Commercial |
$245.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.28
|
|
|
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$195.05
|
|
|
Service Code
|
NDC 67877-544-88
|
| Hospital Charge Code |
9501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.54 |
| Max. Negotiated Rate |
$195.05 |
| Rate for Payer: Aetna Commercial |
$175.54
|
| Rate for Payer: ASR ASR |
$189.20
|
| Rate for Payer: BCBS Trust/PPO |
$151.22
|
| Rate for Payer: BCN Commercial |
$151.22
|
| Rate for Payer: Cash Price |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$183.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.04
|
| Rate for Payer: Healthscope Commercial |
$195.05
|
| Rate for Payer: Healthscope Whirlpool |
$189.20
|
| Rate for Payer: Mclaren Commercial |
$175.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.64
|
|
|
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$415.95
|
|
|
Service Code
|
NDC 0093-4175-73
|
| Hospital Charge Code |
9501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.16 |
| Max. Negotiated Rate |
$415.95 |
| Rate for Payer: Aetna Commercial |
$374.36
|
| Rate for Payer: ASR ASR |
$403.47
|
| Rate for Payer: BCBS Trust/PPO |
$322.49
|
| Rate for Payer: BCN Commercial |
$322.49
|
| Rate for Payer: Cash Price |
$332.76
|
| Rate for Payer: Cofinity Commercial |
$390.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.76
|
| Rate for Payer: Healthscope Commercial |
$415.95
|
| Rate for Payer: Healthscope Whirlpool |
$403.47
|
| Rate for Payer: Mclaren Commercial |
$374.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$353.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.04
|
|
|
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$446.50
|
|
|
Service Code
|
NDC 68180-440-01
|
| Hospital Charge Code |
9501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$312.55 |
| Max. Negotiated Rate |
$446.50 |
| Rate for Payer: Aetna Commercial |
$401.85
|
| Rate for Payer: ASR ASR |
$433.10
|
| Rate for Payer: BCBS Trust/PPO |
$346.17
|
| Rate for Payer: BCN Commercial |
$346.17
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Commercial |
$419.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$446.50
|
| Rate for Payer: Healthscope Whirlpool |
$433.10
|
| Rate for Payer: Mclaren Commercial |
$401.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.92
|
|
|
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$4.82
|
|
|
Service Code
|
NDC 9900-0004-08
|
| Hospital Charge Code |
9501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.34
|
| Rate for Payer: ASR ASR |
$4.68
|
| Rate for Payer: BCBS Trust/PPO |
$3.74
|
| Rate for Payer: BCN Commercial |
$3.74
|
| Rate for Payer: Cash Price |
$3.85
|
| Rate for Payer: Cofinity Commercial |
$4.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.86
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Healthscope Whirlpool |
$4.68
|
| Rate for Payer: Mclaren Commercial |
$4.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.24
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
IP
|
$276.45
|
|
|
Service Code
|
NDC 60687-152-01
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.52 |
| Max. Negotiated Rate |
$276.45 |
| Rate for Payer: Aetna Commercial |
$248.80
|
| Rate for Payer: ASR ASR |
$268.16
|
| Rate for Payer: BCBS Trust/PPO |
$214.33
|
| Rate for Payer: BCN Commercial |
$214.33
|
| Rate for Payer: Cash Price |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$259.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.16
|
| Rate for Payer: Healthscope Commercial |
$276.45
|
| Rate for Payer: Healthscope Whirlpool |
$268.16
|
| Rate for Payer: Mclaren Commercial |
$248.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.28
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
IP
|
$132.52
|
|
|
Service Code
|
NDC 50268-151-15
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.76 |
| Max. Negotiated Rate |
$132.52 |
| Rate for Payer: Aetna Commercial |
$119.27
|
| Rate for Payer: ASR ASR |
$128.54
|
| Rate for Payer: BCBS Trust/PPO |
$102.74
|
| Rate for Payer: BCN Commercial |
$102.74
|
| Rate for Payer: Cash Price |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$124.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.02
|
| Rate for Payer: Healthscope Commercial |
$132.52
|
| Rate for Payer: Healthscope Whirlpool |
$128.54
|
| Rate for Payer: Mclaren Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.62
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
IP
|
$2.77
|
|
|
Service Code
|
NDC 60687-152-11
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Aetna Commercial |
$2.49
|
| Rate for Payer: ASR ASR |
$2.69
|
| Rate for Payer: BCBS Trust/PPO |
$2.15
|
| Rate for Payer: BCN Commercial |
$2.15
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Cofinity Commercial |
$2.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.22
|
| Rate for Payer: Healthscope Commercial |
$2.77
|
| Rate for Payer: Healthscope Whirlpool |
$2.69
|
| Rate for Payer: Mclaren Commercial |
$2.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.44
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
IP
|
$2.65
|
|
|
Service Code
|
NDC 50268-151-11
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.86 |
| Max. Negotiated Rate |
$2.65 |
| Rate for Payer: Aetna Commercial |
$2.38
|
| Rate for Payer: ASR ASR |
$2.57
|
| Rate for Payer: BCBS Trust/PPO |
$2.05
|
| Rate for Payer: BCN Commercial |
$2.05
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.65
|
| Rate for Payer: Healthscope Whirlpool |
$2.57
|
| Rate for Payer: Mclaren Commercial |
$2.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.33
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
IP
|
$289.05
|
|
|
Service Code
|
NDC 0093-3145-01
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$202.34 |
| Max. Negotiated Rate |
$289.05 |
| Rate for Payer: Aetna Commercial |
$260.14
|
| Rate for Payer: ASR ASR |
$280.38
|
| Rate for Payer: BCBS Trust/PPO |
$224.10
|
| Rate for Payer: BCN Commercial |
$224.10
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$271.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$289.05
|
| Rate for Payer: Healthscope Whirlpool |
$280.38
|
| Rate for Payer: Mclaren Commercial |
$260.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$245.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.36
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
IP
|
$127.30
|
|
|
Service Code
|
NDC 50268-152-15
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.11 |
| Max. Negotiated Rate |
$127.30 |
| Rate for Payer: Aetna Commercial |
$114.57
|
| Rate for Payer: ASR ASR |
$123.48
|
| Rate for Payer: BCBS Trust/PPO |
$98.70
|
| Rate for Payer: BCN Commercial |
$98.70
|
| Rate for Payer: Cash Price |
$101.84
|
| Rate for Payer: Cofinity Commercial |
$119.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.84
|
| Rate for Payer: Healthscope Commercial |
$127.30
|
| Rate for Payer: Healthscope Whirlpool |
$123.48
|
| Rate for Payer: Mclaren Commercial |
$114.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.02
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
IP
|
$254.60
|
|
|
Service Code
|
NDC 68180-122-01
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.22 |
| Max. Negotiated Rate |
$254.60 |
| Rate for Payer: Aetna Commercial |
$229.14
|
| Rate for Payer: ASR ASR |
$246.96
|
| Rate for Payer: BCBS Trust/PPO |
$197.39
|
| Rate for Payer: BCN Commercial |
$197.39
|
| Rate for Payer: Cash Price |
$203.68
|
| Rate for Payer: Cofinity Commercial |
$239.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.68
|
| Rate for Payer: Healthscope Commercial |
$254.60
|
| Rate for Payer: Healthscope Whirlpool |
$246.96
|
| Rate for Payer: Mclaren Commercial |
$229.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.05
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
IP
|
$277.30
|
|
|
Service Code
|
NDC 67877-219-01
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$194.11 |
| Max. Negotiated Rate |
$277.30 |
| Rate for Payer: Aetna Commercial |
$249.57
|
| Rate for Payer: ASR ASR |
$268.98
|
| Rate for Payer: BCBS Trust/PPO |
$214.99
|
| Rate for Payer: BCN Commercial |
$214.99
|
| Rate for Payer: Cash Price |
$221.84
|
| Rate for Payer: Cofinity Commercial |
$260.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.84
|
| Rate for Payer: Healthscope Commercial |
$277.30
|
| Rate for Payer: Healthscope Whirlpool |
$268.98
|
| Rate for Payer: Mclaren Commercial |
$249.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.02
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
IP
|
$2.55
|
|
|
Service Code
|
NDC 50268-152-11
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$2.55 |
| Rate for Payer: Aetna Commercial |
$2.30
|
| Rate for Payer: ASR ASR |
$2.47
|
| Rate for Payer: BCBS Trust/PPO |
$1.98
|
| Rate for Payer: BCN Commercial |
$1.98
|
| Rate for Payer: Cash Price |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.04
|
| Rate for Payer: Healthscope Commercial |
$2.55
|
| Rate for Payer: Healthscope Whirlpool |
$2.47
|
| Rate for Payer: Mclaren Commercial |
$2.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.24
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
IP
|
$192.85
|
|
|
Service Code
|
NDC 0093-3147-01
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Aetna Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$187.06
|
| Rate for Payer: BCBS Trust/PPO |
$149.52
|
| Rate for Payer: BCN Commercial |
$149.52
|
| Rate for Payer: Cash Price |
$154.28
|
| Rate for Payer: Cofinity Commercial |
$181.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.28
|
| Rate for Payer: Healthscope Commercial |
$192.85
|
| Rate for Payer: Healthscope Whirlpool |
$187.06
|
| Rate for Payer: Mclaren Commercial |
$173.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.71
|
|
|
CERVICAL SPINAL FUSION WITH CC
|
Facility
IP
|
$37,947.34
|
|
|
Service Code
|
MS-DRG 472
|
| Min. Negotiated Rate |
$25,367.40 |
| Max. Negotiated Rate |
$37,947.34 |
| Rate for Payer: Aetna Medicare |
$26,702.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,378.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,378.16
|
| Rate for Payer: BCBS MAPPO |
$26,702.53
|
| Rate for Payer: BCN Medicare Advantage |
$26,702.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,702.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,702.53
|
| Rate for Payer: Mclaren Medicare |
$26,702.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28,037.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,707.91
|
| Rate for Payer: PACE Medicare |
$25,367.40
|
| Rate for Payer: PACE SWMI |
$26,702.53
|
| Rate for Payer: PHP Commercial |
$29,372.78
|
| Rate for Payer: PHP Medicare Advantage |
$26,702.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,947.34
|
| Rate for Payer: Priority Health Medicare |
$26,702.53
|
| Rate for Payer: Priority Health Narrow Network |
$30,357.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26,702.53
|
| Rate for Payer: UHC Medicare Advantage |
$27,503.61
|
| Rate for Payer: VA VA |
$26,702.53
|
|
|
CERVICAL SPINAL FUSION WITH MCC
|
Facility
IP
|
$63,159.96
|
|
|
Service Code
|
MS-DRG 471
|
| Min. Negotiated Rate |
$41,160.78 |
| Max. Negotiated Rate |
$63,159.96 |
| Rate for Payer: BCBS MAPPO |
$43,327.14
|
| Rate for Payer: BCN Medicare Advantage |
$43,327.14
|
| Rate for Payer: Aetna Medicare |
$43,327.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54,158.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54,158.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,327.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$43,327.14
|
| Rate for Payer: Mclaren Medicare |
$43,327.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45,493.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,826.21
|
| Rate for Payer: PACE Medicare |
$41,160.78
|
| Rate for Payer: PACE SWMI |
$43,327.14
|
| Rate for Payer: PHP Commercial |
$47,659.85
|
| Rate for Payer: PHP Medicare Advantage |
$43,327.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63,159.96
|
| Rate for Payer: Priority Health Medicare |
$43,327.14
|
| Rate for Payer: Priority Health Narrow Network |
$50,527.97
|
| Rate for Payer: Railroad Medicare Medicare |
$43,327.14
|
| Rate for Payer: UHC Medicare Advantage |
$44,626.95
|
| Rate for Payer: VA VA |
$43,327.14
|
|
