|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$6,850.57
|
|
|
Service Code
|
APR-DRG 8103
|
| Min. Negotiated Rate |
$6,193.73 |
| Max. Negotiated Rate |
$6,850.57 |
| Rate for Payer: BCBS Complete |
$6,850.57
|
| Rate for Payer: Mclaren Medicaid |
$6,524.35
|
| Rate for Payer: Meridian Medicaid |
$6,850.57
|
| Rate for Payer: PHP Medicaid |
$6,193.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,524.35
|
| Rate for Payer: UHC Medicaid |
$6,524.35
|
| Rate for Payer: UHCCP Medicaid |
$6,524.35
|
|
|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$3,165.61
|
|
|
Service Code
|
APR-DRG 8101
|
| Min. Negotiated Rate |
$2,862.09 |
| Max. Negotiated Rate |
$3,165.61 |
| Rate for Payer: BCBS Complete |
$3,165.61
|
| Rate for Payer: Mclaren Medicaid |
$3,014.87
|
| Rate for Payer: Meridian Medicaid |
$3,165.61
|
| Rate for Payer: PHP Medicaid |
$2,862.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,014.87
|
| Rate for Payer: UHC Medicaid |
$3,014.87
|
| Rate for Payer: UHCCP Medicaid |
$3,014.87
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna Commercial |
$24.14
|
| Rate for Payer: ASR ASR |
$26.02
|
| Rate for Payer: BCBS Trust/PPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$26.02
|
| Rate for Payer: Healthscope Whirlpool |
$26.82
|
| Rate for Payer: Mclaren Commercial |
$24.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.80
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.61
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna Commercial |
$24.14
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: ASR ASR |
$26.02
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS Trust/PPO |
$22.12
|
| Rate for Payer: BCN Commercial |
$22.12
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$26.02
|
| Rate for Payer: Healthscope Whirlpool |
$26.82
|
| Rate for Payer: Mclaren Commercial |
$24.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.80
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.61
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$22.64
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: Aetna Commercial |
$23.98
|
| Rate for Payer: Aetna Commercial |
$25.19
|
| Rate for Payer: Aetna Medicare |
$9.86
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Aetna Medicare |
$10.35
|
| Rate for Payer: ASR ASR |
$27.15
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: ASR ASR |
$25.84
|
| Rate for Payer: BCBS Complete |
$9.06
|
| Rate for Payer: BCBS Complete |
$11.19
|
| Rate for Payer: BCBS Complete |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$18.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$23.07
|
| Rate for Payer: BCN Commercial |
$18.67
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: BCN Commercial |
$23.07
|
| Rate for Payer: Cash Price |
$21.31
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$21.31
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$25.04
|
| Rate for Payer: Cofinity Commercial |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$26.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Commercial |
$25.84
|
| Rate for Payer: Healthscope Whirlpool |
$26.64
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Healthscope Whirlpool |
$27.98
|
| Rate for Payer: Mclaren Commercial |
$25.19
|
| Rate for Payer: Mclaren Commercial |
$23.98
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$22.95
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$21.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.93
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$22.64
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.98 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: Aetna Commercial |
$25.19
|
| Rate for Payer: Aetna Commercial |
$23.98
|
| Rate for Payer: ASR ASR |
$27.15
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: ASR ASR |
$25.84
|
| Rate for Payer: BCBS Trust/PPO |
$22.98
|
| Rate for Payer: BCBS Trust/PPO |
$18.60
|
| Rate for Payer: BCBS Trust/PPO |
$21.88
|
| Rate for Payer: BCN Commercial |
$21.88
|
| Rate for Payer: BCN Commercial |
$18.60
|
| Rate for Payer: BCN Commercial |
$22.98
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$21.31
|
| Rate for Payer: Cofinity Commercial |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$25.04
|
| Rate for Payer: Cofinity Commercial |
$26.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$25.84
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Healthscope Whirlpool |
$26.64
|
| Rate for Payer: Healthscope Whirlpool |
$27.98
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Mclaren Commercial |
$23.98
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: Mclaren Commercial |
$25.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$21.84
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$22.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.93
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Commercial |
$86.75
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Medicare |
$35.66
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Aetna Medicare |
$36.88
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR ASR |
$93.50
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS Complete |
$39.88
|
| Rate for Payer: BCBS Complete |
$38.56
|
| Rate for Payer: BCBS Trust/PPO |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$79.47
|
| Rate for Payer: BCBS Trust/PPO |
$82.19
|
| Rate for Payer: BCN Commercial |
$60.55
|
| Rate for Payer: BCN Commercial |
$79.47
|
| Rate for Payer: BCN Commercial |
$82.19
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$90.61
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$93.50
|
| Rate for Payer: Healthscope Whirlpool |
$96.39
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Mclaren Commercial |
$86.75
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Nomi Health Commercial |
$79.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.08 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Commercial |
$86.75
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR ASR |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$60.31
|
| Rate for Payer: BCBS Trust/PPO |
$79.16
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: BCN Commercial |
$60.31
|
| Rate for Payer: BCN Commercial |
$81.86
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$90.61
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$93.50
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Whirlpool |
$96.39
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Mclaren Commercial |
$86.75
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$79.04
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.08 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$60.31
|
| Rate for Payer: BCN Commercial |
$81.86
|
| Rate for Payer: BCN Commercial |
$60.31
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
OP
|
$99.69
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$99.69 |
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Aetna Medicare |
$36.88
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS Complete |
$39.88
|
| Rate for Payer: BCBS Trust/PPO |
$82.19
|
| Rate for Payer: BCBS Trust/PPO |
$60.55
|
| Rate for Payer: BCN Commercial |
$60.55
|
| Rate for Payer: BCN Commercial |
$82.19
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION (IV BOLUS)
|
Facility
|
OP
|
$13.95
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Aetna Commercial |
$12.55
|
| Rate for Payer: Aetna Medicare |
$5.16
|
| Rate for Payer: ASR ASR |
$13.53
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.50
|
| Rate for Payer: BCN Commercial |
$11.50
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$13.53
|
| Rate for Payer: Healthscope Whirlpool |
$13.95
|
| Rate for Payer: Mclaren Commercial |
$12.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.16
|
| 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 |
$10.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION (IV BOLUS)
|
Facility
|
IP
|
$13.95
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Aetna Commercial |
$12.55
|
| Rate for Payer: ASR ASR |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.45
|
| Rate for Payer: BCN Commercial |
$11.45
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$13.53
|
| Rate for Payer: Healthscope Whirlpool |
$13.95
|
| Rate for Payer: Mclaren Commercial |
$12.55
|
| 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 |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$12.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$12.70 |
| Rate for Payer: Aetna Commercial |
$11.43
|
| Rate for Payer: Aetna Commercial |
$11.41
|
| Rate for Payer: Aetna Commercial |
$10.47
|
| Rate for Payer: Aetna Commercial |
$11.95
|
| Rate for Payer: Aetna Commercial |
$12.55
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$10.05
|
| Rate for Payer: Aetna Medicare |
$4.69
|
| Rate for Payer: Aetna Medicare |
$4.13
|
| Rate for Payer: Aetna Medicare |
$5.16
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Aetna Medicare |
$6.44
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Aetna Medicare |
$4.30
|
| Rate for Payer: ASR ASR |
$12.32
|
| Rate for Payer: ASR ASR |
$11.28
|
| Rate for Payer: ASR ASR |
$10.83
|
| Rate for Payer: ASR ASR |
$12.29
|
| Rate for Payer: ASR ASR |
$13.53
|
| Rate for Payer: ASR ASR |
$16.88
|
| Rate for Payer: ASR ASR |
$12.88
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS Complete |
$4.65
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS Complete |
$5.08
|
| Rate for Payer: BCBS Trust/PPO |
$10.95
|
| Rate for Payer: BCBS Trust/PPO |
$10.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.21
|
| Rate for Payer: BCBS Trust/PPO |
$9.59
|
| Rate for Payer: BCBS Trust/PPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$11.50
|
| Rate for Payer: BCN Commercial |
$11.50
|
| Rate for Payer: BCN Commercial |
$10.95
|
| Rate for Payer: BCN Commercial |
$9.59
|
| Rate for Payer: BCN Commercial |
$9.21
|
| Rate for Payer: BCN Commercial |
$10.47
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$10.63
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cash Price |
$10.14
|
| Rate for Payer: Cash Price |
$10.63
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cash Price |
$10.14
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cofinity Commercial |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$11.91
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Healthscope Commercial |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$11.28
|
| Rate for Payer: Healthscope Commercial |
$10.83
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Healthscope Whirlpool |
$13.95
|
| Rate for Payer: Healthscope Whirlpool |
$12.70
|
| Rate for Payer: Healthscope Whirlpool |
$11.63
|
| Rate for Payer: Healthscope Whirlpool |
$17.40
|
| Rate for Payer: Healthscope Whirlpool |
$11.16
|
| Rate for Payer: Healthscope Whirlpool |
$13.28
|
| Rate for Payer: Healthscope Whirlpool |
$12.67
|
| Rate for Payer: Mclaren Commercial |
$10.05
|
| Rate for Payer: Mclaren Commercial |
$11.41
|
| Rate for Payer: Mclaren Commercial |
$10.47
|
| Rate for Payer: Mclaren Commercial |
$11.95
|
| Rate for Payer: Mclaren Commercial |
$11.43
|
| Rate for Payer: Mclaren Commercial |
$12.55
|
| Rate for Payer: Mclaren Commercial |
$15.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Nomi Health Commercial |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.39
|
| Rate for Payer: Nomi Health Commercial |
$14.27
|
| Rate for Payer: Nomi Health Commercial |
$10.42
|
| Rate for Payer: Nomi Health Commercial |
$9.16
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Nomi Health Commercial |
$10.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.83
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.86
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$11.38
|
| Rate for Payer: BCN Commercial |
$11.38
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.09
|
| Rate for Payer: Healthscope Commercial |
$13.45
|
| Rate for Payer: Healthscope Whirlpool |
$13.86
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.78
|
| Rate for Payer: Nomi Health Commercial |
$11.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.20
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$11.63
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$11.63 |
| Rate for Payer: Aetna Commercial |
$10.47
|
| Rate for Payer: Aetna Commercial |
$10.05
|
| Rate for Payer: Aetna Commercial |
$11.41
|
| Rate for Payer: Aetna Commercial |
$11.95
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$11.43
|
| Rate for Payer: Aetna Commercial |
$12.55
|
| Rate for Payer: ASR ASR |
$12.88
|
| Rate for Payer: ASR ASR |
$12.29
|
| Rate for Payer: ASR ASR |
$16.88
|
| Rate for Payer: ASR ASR |
$10.83
|
| Rate for Payer: ASR ASR |
$11.28
|
| Rate for Payer: ASR ASR |
$12.32
|
| Rate for Payer: ASR ASR |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$14.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCBS Trust/PPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$9.17
|
| Rate for Payer: BCBS Trust/PPO |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$10.41
|
| Rate for Payer: BCN Commercial |
$11.45
|
| Rate for Payer: BCN Commercial |
$10.41
|
| Rate for Payer: BCN Commercial |
$9.55
|
| Rate for Payer: BCN Commercial |
$10.43
|
| Rate for Payer: BCN Commercial |
$10.91
|
| Rate for Payer: BCN Commercial |
$9.17
|
| Rate for Payer: BCN Commercial |
$14.29
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$10.63
|
| Rate for Payer: Cash Price |
$10.14
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$11.94
|
| Rate for Payer: Cofinity Commercial |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$11.91
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$11.28
|
| Rate for Payer: Healthscope Commercial |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Healthscope Commercial |
$10.83
|
| Rate for Payer: Healthscope Commercial |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Whirlpool |
$13.28
|
| Rate for Payer: Healthscope Whirlpool |
$11.16
|
| Rate for Payer: Healthscope Whirlpool |
$11.63
|
| Rate for Payer: Healthscope Whirlpool |
$13.95
|
| Rate for Payer: Healthscope Whirlpool |
$12.67
|
| Rate for Payer: Healthscope Whirlpool |
$17.40
|
| Rate for Payer: Healthscope Whirlpool |
$12.70
|
| Rate for Payer: Mclaren Commercial |
$10.05
|
| Rate for Payer: Mclaren Commercial |
$11.43
|
| Rate for Payer: Mclaren Commercial |
$10.47
|
| Rate for Payer: Mclaren Commercial |
$11.95
|
| Rate for Payer: Mclaren Commercial |
$12.55
|
| Rate for Payer: Mclaren Commercial |
$11.41
|
| Rate for Payer: Mclaren Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.77
|
| Rate for Payer: Nomi Health Commercial |
$9.16
|
| Rate for Payer: Nomi Health Commercial |
$10.89
|
| Rate for Payer: Nomi Health Commercial |
$10.39
|
| Rate for Payer: Nomi Health Commercial |
$11.44
|
| Rate for Payer: Nomi Health Commercial |
$14.27
|
| Rate for Payer: Nomi Health Commercial |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.69
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$13.86
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$13.86 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$5.13
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$5.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.43
|
| Rate for Payer: BCN Commercial |
$11.43
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.09
|
| Rate for Payer: Healthscope Commercial |
$13.45
|
| Rate for Payer: Healthscope Whirlpool |
$13.86
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.78
|
| Rate for Payer: Nomi Health Commercial |
$11.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.18
|
| Rate for Payer: Priority Health Narrow Network |
$1.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.20
|
|
|
HEPARIN (PORCINE) IN D5W 25,000 UNIT/250 ML (UNITS/HR)
|
Facility
|
OP
|
$103.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164950
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$103.39 |
| Rate for Payer: Aetna Commercial |
$93.06
|
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Aetna Medicare |
$38.26
|
| Rate for Payer: Aetna Medicare |
$36.88
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$100.29
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: BCBS Complete |
$41.36
|
| Rate for Payer: BCBS Complete |
$39.88
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS Trust/PPO |
$85.25
|
| Rate for Payer: BCBS Trust/PPO |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$82.19
|
| Rate for Payer: BCN Commercial |
$85.25
|
| Rate for Payer: BCN Commercial |
$60.55
|
| Rate for Payer: BCN Commercial |
$82.19
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$97.19
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Commercial |
$100.29
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$103.39
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Mclaren Commercial |
$93.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Nomi Health Commercial |
$84.78
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.99
|
|
|
HEPARIN (PORCINE) IN D5W 25,000 UNIT/250 ML (UNITS/HR)
|
Facility
|
IP
|
$103.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164950
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$103.39 |
| Rate for Payer: Aetna Commercial |
$93.06
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$100.29
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$84.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.31
|
| Rate for Payer: BCN Commercial |
$60.31
|
| Rate for Payer: BCN Commercial |
$84.91
|
| Rate for Payer: BCN Commercial |
$81.86
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$82.72
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$97.19
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$100.29
|
| Rate for Payer: Healthscope Commercial |
$96.70
|
| Rate for Payer: Healthscope Whirlpool |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$99.69
|
| Rate for Payer: Healthscope Whirlpool |
$103.39
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Mclaren Commercial |
$93.06
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.89
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Nomi Health Commercial |
$84.78
|
| Rate for Payer: Nomi Health Commercial |
$81.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.99
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Medicare |
$4.07
|
| Rate for Payer: Aetna Medicare |
$4.81
|
| Rate for Payer: ASR ASR |
$12.61
|
| Rate for Payer: ASR ASR |
$10.67
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCBS Trust/PPO |
$9.07
|
| Rate for Payer: BCN Commercial |
$9.07
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$10.34
|
| Rate for Payer: Cofinity Commercial |
$12.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$12.61
|
| Rate for Payer: Healthscope Commercial |
$10.67
|
| Rate for Payer: Healthscope Whirlpool |
$13.00
|
| Rate for Payer: Healthscope Whirlpool |
$11.00
|
| Rate for Payer: Mclaren Commercial |
$11.70
|
| Rate for Payer: Mclaren Commercial |
$9.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: Nomi Health Commercial |
$10.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.44
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: ASR ASR |
$12.61
|
| Rate for Payer: ASR ASR |
$10.67
|
| Rate for Payer: BCBS Trust/PPO |
$10.68
|
| Rate for Payer: BCBS Trust/PPO |
$9.03
|
| Rate for Payer: BCN Commercial |
$10.68
|
| Rate for Payer: BCN Commercial |
$9.03
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$10.34
|
| Rate for Payer: Cofinity Commercial |
$12.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$10.67
|
| Rate for Payer: Healthscope Commercial |
$12.61
|
| Rate for Payer: Healthscope Whirlpool |
$13.00
|
| Rate for Payer: Healthscope Whirlpool |
$11.00
|
| Rate for Payer: Mclaren Commercial |
$11.70
|
| Rate for Payer: Mclaren Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.44
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$4,332.35
|
|
|
Service Code
|
APR-DRG 2792
|
| Min. Negotiated Rate |
$3,916.97 |
| Max. Negotiated Rate |
$4,332.35 |
| Rate for Payer: BCBS Complete |
$4,332.35
|
| Rate for Payer: Mclaren Medicaid |
$4,126.05
|
| Rate for Payer: Meridian Medicaid |
$4,332.35
|
| Rate for Payer: PHP Medicaid |
$3,916.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,126.05
|
| Rate for Payer: UHC Medicaid |
$4,126.05
|
| Rate for Payer: UHCCP Medicaid |
$4,126.05
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$6,666.37
|
|
|
Service Code
|
APR-DRG 2793
|
| Min. Negotiated Rate |
$6,027.20 |
| Max. Negotiated Rate |
$6,666.37 |
| Rate for Payer: BCBS Complete |
$6,666.37
|
| Rate for Payer: Mclaren Medicaid |
$6,348.93
|
| Rate for Payer: Meridian Medicaid |
$6,666.37
|
| Rate for Payer: PHP Medicaid |
$6,027.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,348.93
|
| Rate for Payer: UHC Medicaid |
$6,348.93
|
| Rate for Payer: UHCCP Medicaid |
$6,348.93
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$15,330.53
|
|
|
Service Code
|
APR-DRG 2794
|
| Min. Negotiated Rate |
$13,860.64 |
| Max. Negotiated Rate |
$15,330.53 |
| Rate for Payer: BCBS Complete |
$15,330.53
|
| Rate for Payer: Mclaren Medicaid |
$14,600.51
|
| Rate for Payer: Meridian Medicaid |
$15,330.53
|
| Rate for Payer: PHP Medicaid |
$13,860.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,600.51
|
| Rate for Payer: UHC Medicaid |
$14,600.51
|
| Rate for Payer: UHCCP Medicaid |
$14,600.51
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$2,980.88
|
|
|
Service Code
|
APR-DRG 2791
|
| Min. Negotiated Rate |
$2,695.07 |
| Max. Negotiated Rate |
$2,980.88 |
| Rate for Payer: BCBS Complete |
$2,980.88
|
| Rate for Payer: Mclaren Medicaid |
$2,838.93
|
| Rate for Payer: Meridian Medicaid |
$2,980.88
|
| Rate for Payer: PHP Medicaid |
$2,695.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.93
|
| Rate for Payer: UHC Medicaid |
$2,838.93
|
| Rate for Payer: UHCCP Medicaid |
$2,838.93
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$510.53
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$510.53 |
| Rate for Payer: Aetna Commercial |
$459.47
|
| Rate for Payer: Aetna Medicare |
$140.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.26
|
| Rate for Payer: ASR ASR |
$495.21
|
| Rate for Payer: BCBS Complete |
$77.00
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$420.93
|
| Rate for Payer: BCN Commercial |
$420.93
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cofinity Commercial |
$479.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$495.21
|
| Rate for Payer: Healthscope Whirlpool |
$510.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.21
|
| Rate for Payer: Mclaren Commercial |
$459.47
|
| Rate for Payer: Mclaren Medicaid |
$140.21
|
| Rate for Payer: Mclaren Medicare |
$140.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Meridian Medicaid |
$77.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.95
|
| Rate for Payer: Nomi Health Commercial |
$418.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.89
|
| Rate for Payer: PACE Medicare |
$133.20
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Commercial |
$154.23
|
| Rate for Payer: PHP Medicaid |
$75.15
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.03
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Priority Health Narrow Network |
$114.42
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$217.33
|
| Rate for Payer: UHC Medicaid |
$73.33
|
| Rate for Payer: UHCCP DNSP |
$140.21
|
| Rate for Payer: UHCCP Medicaid |
$73.33
|
| Rate for Payer: VA VA |
$140.21
|
|
