|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$176.70
|
|
|
Service Code
|
NDC 68180072204
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.38 |
| Max. Negotiated Rate |
$176.70 |
| Rate for Payer: Aetna Commercial |
$159.03
|
| Rate for Payer: Aetna Medicare |
$65.38
|
| Rate for Payer: ASR ASR |
$171.40
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS Trust/PPO |
$145.69
|
| Rate for Payer: BCN Commercial |
$145.69
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$166.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Healthscope Commercial |
$171.40
|
| Rate for Payer: Healthscope Whirlpool |
$176.70
|
| Rate for Payer: Mclaren Commercial |
$159.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.82
|
| Rate for Payer: Priority Health Narrow Network |
$123.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.50
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$221.35
|
|
|
Service Code
|
NDC 68180072205
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.90 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Aetna Commercial |
$199.22
|
| Rate for Payer: Aetna Medicare |
$81.90
|
| Rate for Payer: ASR ASR |
$214.71
|
| Rate for Payer: BCBS Complete |
$88.54
|
| Rate for Payer: BCBS Trust/PPO |
$182.50
|
| Rate for Payer: BCN Commercial |
$182.50
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$208.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$214.71
|
| Rate for Payer: Healthscope Whirlpool |
$221.35
|
| Rate for Payer: Mclaren Commercial |
$199.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: Nomi Health Commercial |
$181.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$193.95
|
| Rate for Payer: Priority Health Narrow Network |
$155.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.79
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$176.70
|
|
|
Service Code
|
NDC 68180072204
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.53 |
| Max. Negotiated Rate |
$176.70 |
| Rate for Payer: Aetna Commercial |
$159.03
|
| Rate for Payer: ASR ASR |
$171.40
|
| Rate for Payer: BCBS Trust/PPO |
$145.11
|
| Rate for Payer: BCN Commercial |
$145.11
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$166.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Healthscope Commercial |
$171.40
|
| Rate for Payer: Healthscope Whirlpool |
$176.70
|
| Rate for Payer: Mclaren Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.50
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$262.20
|
|
|
Service Code
|
NDC 65862017760
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.65 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: ASR ASR |
$254.33
|
| Rate for Payer: BCBS Trust/PPO |
$215.32
|
| Rate for Payer: BCN Commercial |
$215.32
|
| Rate for Payer: Cash Price |
$209.76
|
| Rate for Payer: Cofinity Commercial |
$246.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.76
|
| Rate for Payer: Healthscope Commercial |
$254.33
|
| Rate for Payer: Healthscope Whirlpool |
$262.20
|
| Rate for Payer: Mclaren Commercial |
$235.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.87
|
| Rate for Payer: Nomi Health Commercial |
$215.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.74
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$418.69
|
|
|
Service Code
|
NDC 60687069921
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.92 |
| Max. Negotiated Rate |
$418.69 |
| Rate for Payer: Aetna Commercial |
$376.82
|
| Rate for Payer: Aetna Medicare |
$154.92
|
| Rate for Payer: ASR ASR |
$406.13
|
| Rate for Payer: BCBS Complete |
$167.48
|
| Rate for Payer: BCBS Trust/PPO |
$345.21
|
| Rate for Payer: BCN Commercial |
$345.21
|
| Rate for Payer: Cash Price |
$334.95
|
| Rate for Payer: Cofinity Commercial |
$393.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.95
|
| Rate for Payer: Healthscope Commercial |
$406.13
|
| Rate for Payer: Healthscope Whirlpool |
$418.69
|
| Rate for Payer: Mclaren Commercial |
$376.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$355.89
|
| Rate for Payer: Nomi Health Commercial |
$343.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$366.86
|
| Rate for Payer: Priority Health Narrow Network |
$293.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.45
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$13.96
|
|
|
Service Code
|
NDC 60687069911
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$12.56
|
| Rate for Payer: Aetna Medicare |
$5.16
|
| Rate for Payer: ASR ASR |
$13.54
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.51
|
| Rate for Payer: BCN Commercial |
$11.51
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.54
|
| Rate for Payer: Healthscope Whirlpool |
$13.96
|
| Rate for Payer: Mclaren Commercial |
$12.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.23
|
| Rate for Payer: Priority Health Narrow Network |
$9.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$13.96
|
|
|
Service Code
|
NDC 60687069911
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$12.56
|
| Rate for Payer: ASR ASR |
$13.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$11.46
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.54
|
| Rate for Payer: Healthscope Whirlpool |
$13.96
|
| Rate for Payer: Mclaren Commercial |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$262.20
|
|
|
Service Code
|
NDC 65862017760
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.01 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Aetna Commercial |
$235.98
|
| Rate for Payer: Aetna Medicare |
$97.01
|
| Rate for Payer: ASR ASR |
$254.33
|
| Rate for Payer: BCBS Complete |
$104.88
|
| Rate for Payer: BCBS Trust/PPO |
$216.18
|
| Rate for Payer: BCN Commercial |
$216.18
|
| Rate for Payer: Cash Price |
$209.76
|
| Rate for Payer: Cofinity Commercial |
$246.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.76
|
| Rate for Payer: Healthscope Commercial |
$254.33
|
| Rate for Payer: Healthscope Whirlpool |
$262.20
|
| Rate for Payer: Mclaren Commercial |
$235.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.87
|
| Rate for Payer: Nomi Health Commercial |
$215.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$229.74
|
| Rate for Payer: Priority Health Narrow Network |
$183.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.74
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$418.69
|
|
|
Service Code
|
NDC 60687069921
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$314.02 |
| Max. Negotiated Rate |
$418.69 |
| Rate for Payer: Aetna Commercial |
$376.82
|
| Rate for Payer: ASR ASR |
$406.13
|
| Rate for Payer: BCBS Trust/PPO |
$343.83
|
| Rate for Payer: BCN Commercial |
$343.83
|
| Rate for Payer: Cash Price |
$334.95
|
| Rate for Payer: Cofinity Commercial |
$393.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.95
|
| Rate for Payer: Healthscope Commercial |
$406.13
|
| Rate for Payer: Healthscope Whirlpool |
$418.69
|
| Rate for Payer: Mclaren Commercial |
$376.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$355.89
|
| Rate for Payer: Nomi Health Commercial |
$343.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.45
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$17.35
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16369
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$17.35 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Commercial |
$15.18
|
| Rate for Payer: Aetna Commercial |
$16.27
|
| Rate for Payer: Aetna Commercial |
$20.15
|
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: ASR ASR |
$21.71
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: ASR ASR |
$28.13
|
| Rate for Payer: ASR ASR |
$16.36
|
| Rate for Payer: ASR ASR |
$16.83
|
| Rate for Payer: ASR ASR |
$20.02
|
| Rate for Payer: ASR ASR |
$22.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.81
|
| Rate for Payer: BCBS Trust/PPO |
$18.84
|
| Rate for Payer: BCBS Trust/PPO |
$18.38
|
| Rate for Payer: BCBS Trust/PPO |
$14.24
|
| Rate for Payer: BCBS Trust/PPO |
$13.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.95
|
| Rate for Payer: BCBS Trust/PPO |
$14.84
|
| Rate for Payer: BCN Commercial |
$18.84
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: BCN Commercial |
$14.24
|
| Rate for Payer: BCN Commercial |
$16.95
|
| Rate for Payer: BCN Commercial |
$18.38
|
| Rate for Payer: BCN Commercial |
$13.85
|
| Rate for Payer: BCN Commercial |
$23.81
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$13.49
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$18.35
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$21.56
|
| Rate for Payer: Cofinity Commercial |
$16.31
|
| Rate for Payer: Cofinity Commercial |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$21.04
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$17.53
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Healthscope Commercial |
$22.25
|
| Rate for Payer: Healthscope Commercial |
$28.13
|
| Rate for Payer: Healthscope Whirlpool |
$22.38
|
| Rate for Payer: Healthscope Whirlpool |
$16.86
|
| Rate for Payer: Healthscope Whirlpool |
$17.35
|
| Rate for Payer: Healthscope Whirlpool |
$22.94
|
| Rate for Payer: Healthscope Whirlpool |
$18.08
|
| Rate for Payer: Healthscope Whirlpool |
$29.00
|
| Rate for Payer: Healthscope Whirlpool |
$20.64
|
| Rate for Payer: Mclaren Commercial |
$15.18
|
| Rate for Payer: Mclaren Commercial |
$18.57
|
| Rate for Payer: Mclaren Commercial |
$15.61
|
| Rate for Payer: Mclaren Commercial |
$20.15
|
| Rate for Payer: Mclaren Commercial |
$20.65
|
| Rate for Payer: Mclaren Commercial |
$16.27
|
| Rate for Payer: Mclaren Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: Nomi Health Commercial |
$18.35
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Nomi Health Commercial |
$18.81
|
| Rate for Payer: Nomi Health Commercial |
$23.78
|
| Rate for Payer: Nomi Health Commercial |
$14.22
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.70
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$20.64
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16369
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$20.64 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Commercial |
$16.27
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Commercial |
$20.15
|
| Rate for Payer: Aetna Commercial |
$20.65
|
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna Commercial |
$15.18
|
| Rate for Payer: Aetna Medicare |
$6.69
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Aetna Medicare |
$7.63
|
| Rate for Payer: Aetna Medicare |
$6.42
|
| Rate for Payer: ASR ASR |
$20.02
|
| Rate for Payer: ASR ASR |
$16.83
|
| Rate for Payer: ASR ASR |
$16.36
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: ASR ASR |
$22.25
|
| Rate for Payer: ASR ASR |
$28.13
|
| Rate for Payer: ASR ASR |
$21.71
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$9.18
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Complete |
$6.94
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS Complete |
$8.25
|
| Rate for Payer: BCBS Trust/PPO |
$18.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.01
|
| Rate for Payer: BCBS Trust/PPO |
$14.90
|
| Rate for Payer: BCBS Trust/PPO |
$13.91
|
| Rate for Payer: BCBS Trust/PPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$23.91
|
| Rate for Payer: BCBS Trust/PPO |
$18.91
|
| Rate for Payer: BCN Commercial |
$18.91
|
| Rate for Payer: BCN Commercial |
$18.46
|
| Rate for Payer: BCN Commercial |
$14.30
|
| Rate for Payer: BCN Commercial |
$13.91
|
| Rate for Payer: BCN Commercial |
$17.01
|
| Rate for Payer: BCN Commercial |
$14.90
|
| Rate for Payer: BCN Commercial |
$23.91
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$13.49
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$18.35
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$18.35
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$16.31
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Commercial |
$21.04
|
| Rate for Payer: Cofinity Commercial |
$21.56
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.35
|
| Rate for Payer: Healthscope Commercial |
$22.25
|
| Rate for Payer: Healthscope Commercial |
$17.53
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Healthscope Commercial |
$28.13
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Whirlpool |
$22.94
|
| Rate for Payer: Healthscope Whirlpool |
$20.64
|
| Rate for Payer: Healthscope Whirlpool |
$17.35
|
| Rate for Payer: Healthscope Whirlpool |
$29.00
|
| Rate for Payer: Healthscope Whirlpool |
$16.86
|
| Rate for Payer: Healthscope Whirlpool |
$22.38
|
| Rate for Payer: Healthscope Whirlpool |
$18.08
|
| Rate for Payer: Mclaren Commercial |
$15.18
|
| Rate for Payer: Mclaren Commercial |
$16.27
|
| Rate for Payer: Mclaren Commercial |
$15.61
|
| Rate for Payer: Mclaren Commercial |
$20.15
|
| Rate for Payer: Mclaren Commercial |
$18.57
|
| Rate for Payer: Mclaren Commercial |
$20.65
|
| Rate for Payer: Mclaren Commercial |
$26.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.50
|
| Rate for Payer: Nomi Health Commercial |
$14.22
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Nomi Health Commercial |
$23.78
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: Nomi Health Commercial |
$18.81
|
| Rate for Payer: Nomi Health Commercial |
$18.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.84
|
|
|
CEFEPIME 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$18.08
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.56 |
| Max. Negotiated Rate |
$18.08 |
| Rate for Payer: Aetna Commercial |
$16.27
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: BCBS Trust/PPO |
$14.84
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$17.53
|
| Rate for Payer: Healthscope Whirlpool |
$18.08
|
| Rate for Payer: Mclaren Commercial |
$16.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.91
|
|
|
CEFEPIME 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$18.08
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$18.08 |
| Rate for Payer: Aetna Commercial |
$16.27
|
| Rate for Payer: Aetna Medicare |
$6.69
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS Trust/PPO |
$14.90
|
| Rate for Payer: BCN Commercial |
$14.90
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$17.53
|
| Rate for Payer: Healthscope Whirlpool |
$18.08
|
| Rate for Payer: Mclaren Commercial |
$16.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.91
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$19.58
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Commercial |
$27.05
|
| Rate for Payer: Aetna Commercial |
$38.93
|
| Rate for Payer: Aetna Commercial |
$25.15
|
| Rate for Payer: ASR ASR |
$27.10
|
| Rate for Payer: ASR ASR |
$18.99
|
| Rate for Payer: ASR ASR |
$31.45
|
| Rate for Payer: ASR ASR |
$24.89
|
| Rate for Payer: ASR ASR |
$29.15
|
| Rate for Payer: ASR ASR |
$41.96
|
| Rate for Payer: BCBS Trust/PPO |
$16.08
|
| Rate for Payer: BCBS Trust/PPO |
$24.68
|
| Rate for Payer: BCBS Trust/PPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$26.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.07
|
| Rate for Payer: BCN Commercial |
$26.63
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: BCN Commercial |
$35.52
|
| Rate for Payer: BCN Commercial |
$22.95
|
| Rate for Payer: BCN Commercial |
$21.07
|
| Rate for Payer: BCN Commercial |
$24.68
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cash Price |
$22.35
|
| Rate for Payer: Cash Price |
$24.04
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cash Price |
$34.60
|
| Rate for Payer: Cofinity Commercial |
$24.12
|
| Rate for Payer: Cofinity Commercial |
$28.25
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$26.27
|
| Rate for Payer: Cofinity Commercial |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$40.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.60
|
| Rate for Payer: Healthscope Commercial |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$29.15
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Commercial |
$41.96
|
| Rate for Payer: Healthscope Commercial |
$27.10
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Healthscope Whirlpool |
$27.94
|
| Rate for Payer: Healthscope Whirlpool |
$30.05
|
| Rate for Payer: Healthscope Whirlpool |
$25.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.42
|
| Rate for Payer: Healthscope Whirlpool |
$19.58
|
| Rate for Payer: Healthscope Whirlpool |
$43.25
|
| Rate for Payer: Mclaren Commercial |
$29.18
|
| Rate for Payer: Mclaren Commercial |
$38.93
|
| Rate for Payer: Mclaren Commercial |
$25.15
|
| Rate for Payer: Mclaren Commercial |
$17.62
|
| Rate for Payer: Mclaren Commercial |
$23.09
|
| Rate for Payer: Mclaren Commercial |
$27.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.56
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Nomi Health Commercial |
$24.64
|
| Rate for Payer: Nomi Health Commercial |
$16.05
|
| Rate for Payer: Nomi Health Commercial |
$26.59
|
| Rate for Payer: Nomi Health Commercial |
$35.47
|
| Rate for Payer: Nomi Health Commercial |
$22.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.53
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$43.25
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$43.25 |
| Rate for Payer: Aetna Commercial |
$38.93
|
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Commercial |
$25.15
|
| Rate for Payer: Aetna Commercial |
$27.05
|
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna Medicare |
$11.12
|
| Rate for Payer: Aetna Medicare |
$10.34
|
| Rate for Payer: Aetna Medicare |
$9.49
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: ASR ASR |
$24.89
|
| Rate for Payer: ASR ASR |
$41.96
|
| Rate for Payer: ASR ASR |
$31.45
|
| Rate for Payer: ASR ASR |
$18.99
|
| Rate for Payer: ASR ASR |
$27.10
|
| Rate for Payer: ASR ASR |
$29.15
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS Complete |
$12.02
|
| Rate for Payer: BCBS Complete |
$17.30
|
| Rate for Payer: BCBS Complete |
$11.18
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCBS Trust/PPO |
$24.78
|
| Rate for Payer: BCBS Trust/PPO |
$23.04
|
| Rate for Payer: BCBS Trust/PPO |
$16.14
|
| Rate for Payer: BCBS Trust/PPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$35.66
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: BCN Commercial |
$21.16
|
| Rate for Payer: BCN Commercial |
$16.14
|
| Rate for Payer: BCN Commercial |
$23.04
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: BCN Commercial |
$24.78
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$22.35
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cash Price |
$22.35
|
| Rate for Payer: Cash Price |
$24.04
|
| Rate for Payer: Cash Price |
$24.04
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$34.60
|
| Rate for Payer: Cash Price |
$34.60
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$40.66
|
| Rate for Payer: Cofinity Commercial |
$24.12
|
| Rate for Payer: Cofinity Commercial |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$28.25
|
| Rate for Payer: Cofinity Commercial |
$26.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.35
|
| Rate for Payer: Healthscope Commercial |
$27.10
|
| Rate for Payer: Healthscope Commercial |
$29.15
|
| Rate for Payer: Healthscope Commercial |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Healthscope Commercial |
$41.96
|
| Rate for Payer: Healthscope Whirlpool |
$30.05
|
| Rate for Payer: Healthscope Whirlpool |
$25.66
|
| Rate for Payer: Healthscope Whirlpool |
$19.58
|
| Rate for Payer: Healthscope Whirlpool |
$27.94
|
| Rate for Payer: Healthscope Whirlpool |
$32.42
|
| Rate for Payer: Healthscope Whirlpool |
$43.25
|
| Rate for Payer: Mclaren Commercial |
$23.09
|
| Rate for Payer: Mclaren Commercial |
$38.93
|
| Rate for Payer: Mclaren Commercial |
$29.18
|
| Rate for Payer: Mclaren Commercial |
$17.62
|
| Rate for Payer: Mclaren Commercial |
$25.15
|
| Rate for Payer: Mclaren Commercial |
$27.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.64
|
| Rate for Payer: Nomi Health Commercial |
$16.05
|
| Rate for Payer: Nomi Health Commercial |
$26.59
|
| Rate for Payer: Nomi Health Commercial |
$24.64
|
| Rate for Payer: Nomi Health Commercial |
$22.91
|
| Rate for Payer: Nomi Health Commercial |
$35.47
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.06
|
|
|
CEFEPIME 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$19.58
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301707
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: ASR ASR |
$18.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.08
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.66
|
| Rate for Payer: Healthscope Commercial |
$18.99
|
| Rate for Payer: Healthscope Whirlpool |
$19.58
|
| Rate for Payer: Mclaren Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.64
|
| Rate for Payer: Nomi Health Commercial |
$16.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.23
|
|
|
CEFEPIME 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$19.58
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301707
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: ASR ASR |
$18.99
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS Trust/PPO |
$16.14
|
| Rate for Payer: BCN Commercial |
$16.14
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cash Price |
$15.66
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.66
|
| Rate for Payer: Healthscope Commercial |
$18.99
|
| Rate for Payer: Healthscope Whirlpool |
$19.58
|
| Rate for Payer: Mclaren Commercial |
$17.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.64
|
| Rate for Payer: Nomi Health Commercial |
$16.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.23
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM IM SOLUTION
|
Facility
|
IP
|
$23.78
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
150848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.84 |
| Max. Negotiated Rate |
$23.78 |
| Rate for Payer: Aetna Commercial |
$21.40
|
| Rate for Payer: ASR ASR |
$23.07
|
| Rate for Payer: BCBS Trust/PPO |
$19.53
|
| Rate for Payer: BCN Commercial |
$19.53
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.02
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Whirlpool |
$23.78
|
| Rate for Payer: Mclaren Commercial |
$21.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.21
|
| Rate for Payer: Nomi Health Commercial |
$19.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.93
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM IM SOLUTION
|
Facility
|
OP
|
$23.78
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
150848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$23.78 |
| Rate for Payer: Aetna Commercial |
$21.40
|
| Rate for Payer: Aetna Medicare |
$8.80
|
| Rate for Payer: ASR ASR |
$23.07
|
| Rate for Payer: BCBS Complete |
$9.51
|
| Rate for Payer: BCBS Trust/PPO |
$19.61
|
| Rate for Payer: BCN Commercial |
$19.61
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.02
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Whirlpool |
$23.78
|
| Rate for Payer: Mclaren Commercial |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.21
|
| Rate for Payer: Nomi Health Commercial |
$19.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.93
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$18.15
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9487
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Commercial |
$13.35
|
| Rate for Payer: Aetna Commercial |
$12.25
|
| Rate for Payer: Aetna Commercial |
$21.40
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Commercial |
$26.29
|
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Medicare |
$5.49
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Aetna Medicare |
$9.68
|
| Rate for Payer: Aetna Medicare |
$8.80
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna Medicare |
$5.04
|
| Rate for Payer: ASR ASR |
$17.61
|
| Rate for Payer: ASR ASR |
$13.21
|
| Rate for Payer: ASR ASR |
$12.87
|
| Rate for Payer: ASR ASR |
$14.39
|
| Rate for Payer: ASR ASR |
$25.37
|
| Rate for Payer: ASR ASR |
$28.34
|
| Rate for Payer: ASR ASR |
$23.07
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS Complete |
$10.46
|
| Rate for Payer: BCBS Complete |
$11.69
|
| Rate for Payer: BCBS Complete |
$9.51
|
| Rate for Payer: BCBS Complete |
$5.45
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS Trust/PPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$14.97
|
| Rate for Payer: BCBS Trust/PPO |
$12.23
|
| Rate for Payer: BCBS Trust/PPO |
$10.94
|
| Rate for Payer: BCBS Trust/PPO |
$11.23
|
| Rate for Payer: BCBS Trust/PPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$21.57
|
| Rate for Payer: BCN Commercial |
$21.57
|
| Rate for Payer: BCN Commercial |
$19.61
|
| Rate for Payer: BCN Commercial |
$11.23
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: BCN Commercial |
$14.97
|
| Rate for Payer: BCN Commercial |
$12.23
|
| Rate for Payer: BCN Commercial |
$24.09
|
| Rate for Payer: Cash Price |
$10.89
|
| Rate for Payer: Cash Price |
$10.89
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cash Price |
$10.61
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cash Price |
$20.93
|
| Rate for Payer: Cash Price |
$14.52
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cash Price |
$20.93
|
| Rate for Payer: Cash Price |
$14.52
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$10.61
|
| Rate for Payer: Cofinity Commercial |
$17.06
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Cofinity Commercial |
$12.47
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Cofinity Commercial |
$24.59
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.93
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$13.21
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$17.61
|
| Rate for Payer: Healthscope Whirlpool |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$18.15
|
| Rate for Payer: Healthscope Whirlpool |
$13.62
|
| Rate for Payer: Healthscope Whirlpool |
$29.21
|
| Rate for Payer: Healthscope Whirlpool |
$13.27
|
| Rate for Payer: Healthscope Whirlpool |
$23.78
|
| Rate for Payer: Healthscope Whirlpool |
$14.83
|
| Rate for Payer: Mclaren Commercial |
$11.94
|
| Rate for Payer: Mclaren Commercial |
$13.35
|
| Rate for Payer: Mclaren Commercial |
$12.25
|
| Rate for Payer: Mclaren Commercial |
$21.40
|
| Rate for Payer: Mclaren Commercial |
$16.34
|
| Rate for Payer: Mclaren Commercial |
$23.54
|
| Rate for Payer: Mclaren Commercial |
$26.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.23
|
| Rate for Payer: Nomi Health Commercial |
$11.17
|
| Rate for Payer: Nomi Health Commercial |
$12.16
|
| Rate for Payer: Nomi Health Commercial |
$23.96
|
| Rate for Payer: Nomi Health Commercial |
$14.89
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Nomi Health Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$19.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.68
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$13.62
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9487
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$13.62 |
| Rate for Payer: Aetna Commercial |
$12.25
|
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Commercial |
$13.35
|
| Rate for Payer: Aetna Commercial |
$21.40
|
| Rate for Payer: Aetna Commercial |
$26.29
|
| Rate for Payer: Aetna Commercial |
$16.34
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: ASR ASR |
$23.07
|
| Rate for Payer: ASR ASR |
$14.39
|
| Rate for Payer: ASR ASR |
$28.34
|
| Rate for Payer: ASR ASR |
$12.87
|
| Rate for Payer: ASR ASR |
$13.21
|
| Rate for Payer: ASR ASR |
$17.61
|
| Rate for Payer: ASR ASR |
$25.37
|
| Rate for Payer: BCBS Trust/PPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$21.48
|
| Rate for Payer: BCBS Trust/PPO |
$19.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.90
|
| Rate for Payer: BCBS Trust/PPO |
$14.91
|
| Rate for Payer: BCBS Trust/PPO |
$12.18
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: BCN Commercial |
$12.18
|
| Rate for Payer: BCN Commercial |
$11.18
|
| Rate for Payer: BCN Commercial |
$14.91
|
| Rate for Payer: BCN Commercial |
$19.53
|
| Rate for Payer: BCN Commercial |
$10.90
|
| Rate for Payer: BCN Commercial |
$23.99
|
| Rate for Payer: Cash Price |
$10.89
|
| Rate for Payer: Cash Price |
$19.02
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$10.61
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cash Price |
$20.93
|
| Rate for Payer: Cash Price |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$24.59
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$17.06
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Cofinity Commercial |
$12.47
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.37
|
| Rate for Payer: Healthscope Commercial |
$13.21
|
| Rate for Payer: Healthscope Commercial |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$17.61
|
| Rate for Payer: Healthscope Commercial |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$23.07
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Healthscope Whirlpool |
$23.78
|
| Rate for Payer: Healthscope Whirlpool |
$13.27
|
| Rate for Payer: Healthscope Whirlpool |
$13.62
|
| Rate for Payer: Healthscope Whirlpool |
$26.16
|
| Rate for Payer: Healthscope Whirlpool |
$14.83
|
| Rate for Payer: Healthscope Whirlpool |
$29.21
|
| Rate for Payer: Healthscope Whirlpool |
$18.15
|
| Rate for Payer: Mclaren Commercial |
$11.94
|
| Rate for Payer: Mclaren Commercial |
$16.34
|
| Rate for Payer: Mclaren Commercial |
$12.25
|
| Rate for Payer: Mclaren Commercial |
$21.40
|
| Rate for Payer: Mclaren Commercial |
$23.54
|
| Rate for Payer: Mclaren Commercial |
$13.35
|
| Rate for Payer: Mclaren Commercial |
$26.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Nomi Health Commercial |
$19.50
|
| Rate for Payer: Nomi Health Commercial |
$12.16
|
| Rate for Payer: Nomi Health Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$23.96
|
| Rate for Payer: Nomi Health Commercial |
$11.17
|
| Rate for Payer: Nomi Health Commercial |
$14.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.93
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$29.22
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$29.21 |
| Rate for Payer: Aetna Commercial |
$26.29
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: ASR ASR |
$28.34
|
| Rate for Payer: BCBS Complete |
$11.69
|
| Rate for Payer: BCBS Trust/PPO |
$24.09
|
| Rate for Payer: BCN Commercial |
$24.09
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.37
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Healthscope Whirlpool |
$29.21
|
| Rate for Payer: Mclaren Commercial |
$26.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.83
|
| Rate for Payer: Nomi Health Commercial |
$23.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.71
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$29.22
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.91 |
| Max. Negotiated Rate |
$29.21 |
| Rate for Payer: Aetna Commercial |
$26.29
|
| Rate for Payer: ASR ASR |
$28.34
|
| Rate for Payer: BCBS Trust/PPO |
$23.99
|
| Rate for Payer: BCN Commercial |
$23.99
|
| Rate for Payer: Cash Price |
$23.37
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.37
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Healthscope Whirlpool |
$29.21
|
| Rate for Payer: Mclaren Commercial |
$26.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.83
|
| Rate for Payer: Nomi Health Commercial |
$23.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.71
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$16.47
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9488
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$16.46 |
| Rate for Payer: Aetna Commercial |
$14.82
|
| Rate for Payer: Aetna Commercial |
$22.90
|
| Rate for Payer: Aetna Commercial |
$41.32
|
| Rate for Payer: Aetna Medicare |
$9.42
|
| Rate for Payer: Aetna Medicare |
$6.09
|
| Rate for Payer: Aetna Medicare |
$16.99
|
| Rate for Payer: ASR ASR |
$44.53
|
| Rate for Payer: ASR ASR |
$15.97
|
| Rate for Payer: ASR ASR |
$24.68
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Complete |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$37.85
|
| Rate for Payer: BCN Commercial |
$13.58
|
| Rate for Payer: BCN Commercial |
$20.98
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$36.73
|
| Rate for Payer: Cash Price |
$36.73
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$15.48
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.36
|
| Rate for Payer: Healthscope Commercial |
$44.53
|
| Rate for Payer: Healthscope Commercial |
$15.97
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Healthscope Whirlpool |
$25.45
|
| Rate for Payer: Healthscope Whirlpool |
$16.46
|
| Rate for Payer: Healthscope Whirlpool |
$45.91
|
| Rate for Payer: Mclaren Commercial |
$41.32
|
| Rate for Payer: Mclaren Commercial |
$22.90
|
| Rate for Payer: Mclaren Commercial |
$14.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.00
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Nomi Health Commercial |
$13.50
|
| Rate for Payer: Nomi Health Commercial |
$20.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.48
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: Priority Health Narrow Network |
$0.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.49
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.47
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9488
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$16.46 |
| Rate for Payer: Aetna Commercial |
$14.82
|
| Rate for Payer: Aetna Commercial |
$41.32
|
| Rate for Payer: Aetna Commercial |
$22.90
|
| Rate for Payer: ASR ASR |
$44.53
|
| Rate for Payer: ASR ASR |
$15.97
|
| Rate for Payer: ASR ASR |
$24.68
|
| Rate for Payer: BCBS Trust/PPO |
$37.70
|
| Rate for Payer: BCBS Trust/PPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$20.90
|
| Rate for Payer: BCN Commercial |
$20.90
|
| Rate for Payer: BCN Commercial |
$13.52
|
| Rate for Payer: BCN Commercial |
$37.70
|
| Rate for Payer: Cash Price |
$36.73
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$15.48
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.36
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Healthscope Commercial |
$15.97
|
| Rate for Payer: Healthscope Commercial |
$44.53
|
| Rate for Payer: Healthscope Whirlpool |
$25.45
|
| Rate for Payer: Healthscope Whirlpool |
$45.91
|
| Rate for Payer: Healthscope Whirlpool |
$16.46
|
| Rate for Payer: Mclaren Commercial |
$22.90
|
| Rate for Payer: Mclaren Commercial |
$14.82
|
| Rate for Payer: Mclaren Commercial |
$41.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.00
|
| Rate for Payer: Nomi Health Commercial |
$20.87
|
| Rate for Payer: Nomi Health Commercial |
$13.50
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.49
|
|
