|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$368.60
|
|
|
Service Code
|
NDC 60687016301
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.38 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Aetna Commercial |
$331.74
|
| Rate for Payer: Aetna Medicare |
$136.38
|
| Rate for Payer: ASR ASR |
$357.54
|
| Rate for Payer: BCBS Complete |
$147.44
|
| Rate for Payer: BCBS Trust/PPO |
$303.91
|
| Rate for Payer: BCN Commercial |
$303.91
|
| Rate for Payer: Cash Price |
$294.88
|
| Rate for Payer: Cofinity Commercial |
$346.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.88
|
| Rate for Payer: Healthscope Commercial |
$357.54
|
| Rate for Payer: Healthscope Whirlpool |
$368.60
|
| Rate for Payer: Mclaren Commercial |
$331.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.31
|
| Rate for Payer: Nomi Health Commercial |
$302.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$322.97
|
| Rate for Payer: Priority Health Narrow Network |
$258.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.37
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$334.40
|
|
|
Service Code
|
NDC 904733761
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.73 |
| Max. Negotiated Rate |
$334.40 |
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: Aetna Medicare |
$123.73
|
| Rate for Payer: ASR ASR |
$324.37
|
| Rate for Payer: BCBS Complete |
$133.76
|
| Rate for Payer: BCBS Trust/PPO |
$275.71
|
| Rate for Payer: BCN Commercial |
$275.71
|
| Rate for Payer: Cash Price |
$267.52
|
| Rate for Payer: Cofinity Commercial |
$314.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.52
|
| Rate for Payer: Healthscope Commercial |
$324.37
|
| Rate for Payer: Healthscope Whirlpool |
$334.40
|
| Rate for Payer: Mclaren Commercial |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.24
|
| Rate for Payer: Nomi Health Commercial |
$274.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.00
|
| Rate for Payer: Priority Health Narrow Network |
$234.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.27
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$2.58
|
|
|
Service Code
|
NDC 50268015211
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.33
|
| Rate for Payer: ASR ASR |
$2.51
|
| Rate for Payer: BCBS Trust/PPO |
$2.12
|
| Rate for Payer: BCN Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Cofinity Commercial |
$2.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.07
|
| Rate for Payer: Healthscope Commercial |
$2.51
|
| Rate for Payer: Healthscope Whirlpool |
$2.58
|
| Rate for Payer: Mclaren Commercial |
$2.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.20
|
| Rate for Payer: Nomi Health Commercial |
$2.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.27
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
NDC 67877021901
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$336.05 |
| Rate for Payer: Aetna Commercial |
$302.44
|
| Rate for Payer: Aetna Medicare |
$124.34
|
| Rate for Payer: ASR ASR |
$325.97
|
| Rate for Payer: BCBS Complete |
$134.42
|
| Rate for Payer: BCBS Trust/PPO |
$277.07
|
| Rate for Payer: BCN Commercial |
$277.07
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$315.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$325.97
|
| Rate for Payer: Healthscope Whirlpool |
$336.05
|
| Rate for Payer: Mclaren Commercial |
$302.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$294.45
|
| Rate for Payer: Priority Health Narrow Network |
$235.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.72
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$2.58
|
|
|
Service Code
|
NDC 50268015211
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.33
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: ASR ASR |
$2.51
|
| Rate for Payer: BCBS Complete |
$1.03
|
| Rate for Payer: BCBS Trust/PPO |
$2.13
|
| Rate for Payer: BCN Commercial |
$2.13
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Cofinity Commercial |
$2.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.07
|
| Rate for Payer: Healthscope Commercial |
$2.51
|
| Rate for Payer: Healthscope Whirlpool |
$2.58
|
| Rate for Payer: Mclaren Commercial |
$2.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.20
|
| Rate for Payer: Nomi Health Commercial |
$2.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.26
|
| Rate for Payer: Priority Health Narrow Network |
$1.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.27
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$368.60
|
|
|
Service Code
|
NDC 60687016301
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$276.45 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Aetna Commercial |
$331.74
|
| Rate for Payer: ASR ASR |
$357.54
|
| Rate for Payer: BCBS Trust/PPO |
$302.69
|
| Rate for Payer: BCN Commercial |
$302.69
|
| Rate for Payer: Cash Price |
$294.88
|
| Rate for Payer: Cofinity Commercial |
$346.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.88
|
| Rate for Payer: Healthscope Commercial |
$357.54
|
| Rate for Payer: Healthscope Whirlpool |
$368.60
|
| Rate for Payer: Mclaren Commercial |
$331.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.31
|
| Rate for Payer: Nomi Health Commercial |
$302.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.37
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$3.69
|
|
|
Service Code
|
NDC 60687016311
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$3.69 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: ASR ASR |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$3.03
|
| Rate for Payer: BCN Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Healthscope Commercial |
$3.58
|
| Rate for Payer: Healthscope Whirlpool |
$3.69
|
| Rate for Payer: Mclaren Commercial |
$3.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.13
|
| Rate for Payer: Nomi Health Commercial |
$3.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.24
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$192.85
|
|
|
Service Code
|
NDC 93314701
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.64 |
| 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 |
$158.37
|
| Rate for Payer: BCN Commercial |
$158.37
|
| 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 |
$187.06
|
| Rate for Payer: Healthscope Whirlpool |
$192.85
|
| Rate for Payer: Mclaren Commercial |
$173.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.92
|
| Rate for Payer: Nomi Health Commercial |
$158.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.71
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$129.20
|
|
|
Service Code
|
NDC 50268015215
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Aetna Commercial |
$116.28
|
| Rate for Payer: ASR ASR |
$125.32
|
| Rate for Payer: BCBS Trust/PPO |
$106.10
|
| Rate for Payer: BCN Commercial |
$106.10
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cofinity Commercial |
$121.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.36
|
| Rate for Payer: Healthscope Commercial |
$125.32
|
| Rate for Payer: Healthscope Whirlpool |
$129.20
|
| Rate for Payer: Mclaren Commercial |
$116.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.82
|
| Rate for Payer: Nomi Health Commercial |
$105.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.70
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$262.20
|
|
|
Service Code
|
NDC 68180012201
|
| Hospital Charge Code |
9500
|
|
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
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$3.69
|
|
|
Service Code
|
NDC 60687016311
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$3.69 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: ASR ASR |
$3.58
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS Trust/PPO |
$3.04
|
| Rate for Payer: BCN Commercial |
$3.04
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Healthscope Commercial |
$3.58
|
| Rate for Payer: Healthscope Whirlpool |
$3.69
|
| Rate for Payer: Mclaren Commercial |
$3.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.13
|
| Rate for Payer: Nomi Health Commercial |
$3.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.23
|
| Rate for Payer: Priority Health Narrow Network |
$2.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.24
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$336.05
|
|
|
Service Code
|
NDC 67877021901
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$252.04 |
| Max. Negotiated Rate |
$336.05 |
| Rate for Payer: Aetna Commercial |
$302.44
|
| Rate for Payer: ASR ASR |
$325.97
|
| Rate for Payer: BCBS Trust/PPO |
$275.96
|
| Rate for Payer: BCN Commercial |
$275.96
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$315.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$325.97
|
| Rate for Payer: Healthscope Whirlpool |
$336.05
|
| Rate for Payer: Mclaren Commercial |
$302.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.72
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$116.85
|
|
|
Service Code
|
NDC 904733706
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.23 |
| Max. Negotiated Rate |
$116.85 |
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: ASR ASR |
$113.34
|
| Rate for Payer: BCBS Complete |
$46.74
|
| Rate for Payer: BCBS Trust/PPO |
$96.34
|
| Rate for Payer: BCN Commercial |
$96.34
|
| Rate for Payer: Cash Price |
$93.48
|
| Rate for Payer: Cofinity Commercial |
$109.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.48
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Healthscope Whirlpool |
$116.85
|
| Rate for Payer: Mclaren Commercial |
$105.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.32
|
| Rate for Payer: Nomi Health Commercial |
$95.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.38
|
| Rate for Payer: Priority Health Narrow Network |
$81.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.83
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$129.20
|
|
|
Service Code
|
NDC 50268015215
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.80 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Aetna Commercial |
$116.28
|
| Rate for Payer: Aetna Medicare |
$47.80
|
| Rate for Payer: ASR ASR |
$125.32
|
| Rate for Payer: BCBS Complete |
$51.68
|
| Rate for Payer: BCBS Trust/PPO |
$106.53
|
| Rate for Payer: BCN Commercial |
$106.53
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cofinity Commercial |
$121.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.36
|
| Rate for Payer: Healthscope Commercial |
$125.32
|
| Rate for Payer: Healthscope Whirlpool |
$129.20
|
| Rate for Payer: Mclaren Commercial |
$116.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.82
|
| Rate for Payer: Nomi Health Commercial |
$105.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.21
|
| Rate for Payer: Priority Health Narrow Network |
$90.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.70
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$2.34
|
|
|
Service Code
|
NDC 904733735
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$2.34 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare |
$0.86
|
| Rate for Payer: ASR ASR |
$2.27
|
| Rate for Payer: BCBS Complete |
$0.93
|
| Rate for Payer: BCBS Trust/PPO |
$1.93
|
| Rate for Payer: BCN Commercial |
$1.93
|
| Rate for Payer: Cash Price |
$1.87
|
| Rate for Payer: Cofinity Commercial |
$2.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.87
|
| Rate for Payer: Healthscope Commercial |
$2.27
|
| Rate for Payer: Healthscope Whirlpool |
$2.34
|
| Rate for Payer: Mclaren Commercial |
$2.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.99
|
| Rate for Payer: Nomi Health Commercial |
$1.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.05
|
| Rate for Payer: Priority Health Narrow Network |
$1.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.06
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$116.85
|
|
|
Service Code
|
NDC 904733706
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.64 |
| Max. Negotiated Rate |
$116.85 |
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: ASR ASR |
$113.34
|
| Rate for Payer: BCBS Trust/PPO |
$95.96
|
| Rate for Payer: BCN Commercial |
$95.96
|
| Rate for Payer: Cash Price |
$93.48
|
| Rate for Payer: Cofinity Commercial |
$109.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.48
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Healthscope Whirlpool |
$116.85
|
| Rate for Payer: Mclaren Commercial |
$105.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.32
|
| Rate for Payer: Nomi Health Commercial |
$95.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.83
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$192.85
|
|
|
Service Code
|
NDC 93314701
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.35 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Aetna Commercial |
$173.56
|
| Rate for Payer: Aetna Medicare |
$71.35
|
| Rate for Payer: ASR ASR |
$187.06
|
| Rate for Payer: BCBS Complete |
$77.14
|
| Rate for Payer: BCBS Trust/PPO |
$159.00
|
| Rate for Payer: BCN Commercial |
$159.00
|
| 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 |
$187.06
|
| Rate for Payer: Healthscope Whirlpool |
$192.85
|
| Rate for Payer: Mclaren Commercial |
$173.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.92
|
| Rate for Payer: Nomi Health Commercial |
$158.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$168.98
|
| Rate for Payer: Priority Health Narrow Network |
$135.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.71
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$334.40
|
|
|
Service Code
|
NDC 904733761
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$250.80 |
| Max. Negotiated Rate |
$334.40 |
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: ASR ASR |
$324.37
|
| Rate for Payer: BCBS Trust/PPO |
$274.61
|
| Rate for Payer: BCN Commercial |
$274.61
|
| Rate for Payer: Cash Price |
$267.52
|
| Rate for Payer: Cofinity Commercial |
$314.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.52
|
| Rate for Payer: Healthscope Commercial |
$324.37
|
| Rate for Payer: Healthscope Whirlpool |
$334.40
|
| Rate for Payer: Mclaren Commercial |
$300.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.24
|
| Rate for Payer: Nomi Health Commercial |
$274.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.27
|
|
|
CERVICAL SPINAL FUSION WITH CC
|
Facility
|
IP
|
$40,475.88
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$21,821.55 |
| Max. Negotiated Rate |
$40,475.88 |
| Rate for Payer: Aetna Medicare |
$22,970.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,712.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,712.56
|
| Rate for Payer: BCBS MAPPO |
$22,970.05
|
| Rate for Payer: BCN Medicare Advantage |
$22,970.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,970.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,970.05
|
| Rate for Payer: Mclaren Medicare |
$22,970.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,118.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,415.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$25,267.06
|
| Rate for Payer: PACE Medicare |
$21,821.55
|
| Rate for Payer: PACE SWMI |
$22,970.05
|
| Rate for Payer: PHP Commercial |
$25,267.06
|
| Rate for Payer: PHP Medicare Advantage |
$22,970.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40,475.88
|
| Rate for Payer: Priority Health Medicare |
$22,970.05
|
| Rate for Payer: Priority Health Narrow Network |
$32,380.70
|
| Rate for Payer: Railroad Medicare Medicare |
$22,970.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,970.05
|
| Rate for Payer: UHC Exchange |
$35,603.58
|
| Rate for Payer: UHCCP DNSP |
$22,970.05
|
| Rate for Payer: VA VA |
$22,970.05
|
|
|
CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$66,340.54
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$34,700.75 |
| Max. Negotiated Rate |
$66,340.54 |
| Rate for Payer: Aetna Medicare |
$36,527.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,658.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,658.88
|
| Rate for Payer: BCBS MAPPO |
$36,527.10
|
| Rate for Payer: BCN Medicare Advantage |
$36,527.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,527.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$36,527.10
|
| Rate for Payer: Mclaren Medicare |
$36,527.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,353.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,006.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$40,179.81
|
| Rate for Payer: PACE Medicare |
$34,700.75
|
| Rate for Payer: PACE SWMI |
$36,527.10
|
| Rate for Payer: PHP Commercial |
$40,179.81
|
| Rate for Payer: PHP Medicare Advantage |
$36,527.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66,340.54
|
| Rate for Payer: Priority Health Medicare |
$36,527.10
|
| Rate for Payer: Priority Health Narrow Network |
$53,072.43
|
| Rate for Payer: Railroad Medicare Medicare |
$36,527.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36,527.10
|
| Rate for Payer: UHC Exchange |
$56,617.00
|
| Rate for Payer: UHCCP DNSP |
$36,527.10
|
| Rate for Payer: VA VA |
$36,527.10
|
|
|
CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$33,540.53
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$18,368.12 |
| Max. Negotiated Rate |
$33,540.53 |
| Rate for Payer: Aetna Medicare |
$19,334.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,168.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,168.58
|
| Rate for Payer: BCBS MAPPO |
$19,334.86
|
| Rate for Payer: BCN Medicare Advantage |
$19,334.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,334.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,334.86
|
| Rate for Payer: Mclaren Medicare |
$19,334.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,301.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,235.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,268.35
|
| Rate for Payer: PACE Medicare |
$18,368.12
|
| Rate for Payer: PACE SWMI |
$19,334.86
|
| Rate for Payer: PHP Commercial |
$21,268.35
|
| Rate for Payer: PHP Medicare Advantage |
$19,334.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33,540.53
|
| Rate for Payer: Priority Health Medicare |
$19,334.86
|
| Rate for Payer: Priority Health Narrow Network |
$26,832.43
|
| Rate for Payer: Railroad Medicare Medicare |
$19,334.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,334.86
|
| Rate for Payer: UHC Exchange |
$29,969.03
|
| Rate for Payer: UHCCP DNSP |
$19,334.86
|
| Rate for Payer: VA VA |
$19,334.86
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$16,272.75
|
|
|
Service Code
|
APR-DRG 5404
|
| Min. Negotiated Rate |
$14,712.51 |
| Max. Negotiated Rate |
$16,272.75 |
| Rate for Payer: BCBS Complete |
$16,272.75
|
| Rate for Payer: Mclaren Medicaid |
$15,497.86
|
| Rate for Payer: Meridian Medicaid |
$16,272.75
|
| Rate for Payer: PHP Medicaid |
$14,712.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,497.86
|
| Rate for Payer: UHC Medicaid |
$15,497.86
|
| Rate for Payer: UHCCP Medicaid |
$15,497.86
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$4,337.26
|
|
|
Service Code
|
APR-DRG 5401
|
| Min. Negotiated Rate |
$3,921.40 |
| Max. Negotiated Rate |
$4,337.26 |
| Rate for Payer: BCBS Complete |
$4,337.26
|
| Rate for Payer: Mclaren Medicaid |
$4,130.72
|
| Rate for Payer: Meridian Medicaid |
$4,337.26
|
| Rate for Payer: PHP Medicaid |
$3,921.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.72
|
| Rate for Payer: UHC Medicaid |
$4,130.72
|
| Rate for Payer: UHCCP Medicaid |
$4,130.72
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$6,688.17
|
|
|
Service Code
|
APR-DRG 5403
|
| Min. Negotiated Rate |
$6,046.91 |
| Max. Negotiated Rate |
$6,688.17 |
| Rate for Payer: BCBS Complete |
$6,688.17
|
| Rate for Payer: Mclaren Medicaid |
$6,369.69
|
| Rate for Payer: Meridian Medicaid |
$6,688.17
|
| Rate for Payer: PHP Medicaid |
$6,046.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,369.69
|
| Rate for Payer: UHC Medicaid |
$6,369.69
|
| Rate for Payer: UHCCP Medicaid |
$6,369.69
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$5,602.09
|
|
|
Service Code
|
APR-DRG 5402
|
| Min. Negotiated Rate |
$5,064.96 |
| Max. Negotiated Rate |
$5,602.09 |
| Rate for Payer: BCBS Complete |
$5,602.09
|
| Rate for Payer: Mclaren Medicaid |
$5,335.32
|
| Rate for Payer: Meridian Medicaid |
$5,602.09
|
| Rate for Payer: PHP Medicaid |
$5,064.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,335.32
|
| Rate for Payer: UHC Medicaid |
$5,335.32
|
| Rate for Payer: UHCCP Medicaid |
$5,335.32
|
|
