|
MEPOLIZUMAB 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR
|
Facility
|
IP
|
$10,376.55
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
190682
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,782.41 |
| Max. Negotiated Rate |
$10,376.55 |
| Rate for Payer: Aetna Commercial |
$9,338.89
|
| Rate for Payer: ASR ASR |
$10,065.25
|
| Rate for Payer: BCBS Trust/PPO |
$8,521.22
|
| Rate for Payer: BCN Commercial |
$8,521.22
|
| Rate for Payer: Cash Price |
$8,301.24
|
| Rate for Payer: Cofinity Commercial |
$9,753.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,301.24
|
| Rate for Payer: Healthscope Commercial |
$10,065.25
|
| Rate for Payer: Healthscope Whirlpool |
$10,376.55
|
| Rate for Payer: Mclaren Commercial |
$9,338.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,820.07
|
| Rate for Payer: Nomi Health Commercial |
$8,508.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,782.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,131.36
|
|
|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$8,599.21
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$8,599.21 |
| Rate for Payer: Aetna Commercial |
$7,739.29
|
| Rate for Payer: Aetna Medicare |
$31.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.77
|
| Rate for Payer: ASR ASR |
$8,341.24
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$31.82
|
| Rate for Payer: BCBS Trust/PPO |
$7,090.05
|
| Rate for Payer: BCN Commercial |
$7,090.05
|
| Rate for Payer: BCN Medicare Advantage |
$31.82
|
| Rate for Payer: Cash Price |
$6,879.37
|
| Rate for Payer: Cash Price |
$6,879.37
|
| Rate for Payer: Cofinity Commercial |
$8,083.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,879.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$8,341.24
|
| Rate for Payer: Healthscope Whirlpool |
$8,599.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.82
|
| Rate for Payer: Mclaren Commercial |
$7,739.29
|
| Rate for Payer: Mclaren Medicaid |
$31.82
|
| Rate for Payer: Mclaren Medicare |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.41
|
| Rate for Payer: Meridian Medicaid |
$17.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,309.33
|
| Rate for Payer: Nomi Health Commercial |
$7,051.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,449.41
|
| Rate for Payer: PACE Medicare |
$30.23
|
| Rate for Payer: PACE SWMI |
$31.82
|
| Rate for Payer: PHP Commercial |
$35.00
|
| Rate for Payer: PHP Medicaid |
$17.06
|
| Rate for Payer: PHP Medicare Advantage |
$31.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$33.09
|
| Rate for Payer: Priority Health Medicare |
$31.82
|
| Rate for Payer: Priority Health Narrow Network |
$26.47
|
| Rate for Payer: Railroad Medicare Medicare |
$31.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,567.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.82
|
| Rate for Payer: UHC Exchange |
$49.32
|
| Rate for Payer: UHC Medicaid |
$16.64
|
| Rate for Payer: UHCCP DNSP |
$31.82
|
| Rate for Payer: UHCCP Medicaid |
$16.64
|
| Rate for Payer: VA VA |
$31.82
|
|
|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$8,599.21
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,449.41 |
| Max. Negotiated Rate |
$8,599.21 |
| Rate for Payer: Aetna Commercial |
$7,739.29
|
| Rate for Payer: ASR ASR |
$8,341.24
|
| Rate for Payer: BCBS Trust/PPO |
$7,061.67
|
| Rate for Payer: BCN Commercial |
$7,061.67
|
| Rate for Payer: Cash Price |
$6,879.37
|
| Rate for Payer: Cofinity Commercial |
$8,083.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,879.37
|
| Rate for Payer: Healthscope Commercial |
$8,341.24
|
| Rate for Payer: Healthscope Whirlpool |
$8,599.21
|
| Rate for Payer: Mclaren Commercial |
$7,739.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,309.33
|
| Rate for Payer: Nomi Health Commercial |
$7,051.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,449.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,567.31
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$45.52
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.14 |
| Max. Negotiated Rate |
$45.52 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: ASR ASR |
$44.16
|
| Rate for Payer: BCBS Trust/PPO |
$37.38
|
| Rate for Payer: BCN Commercial |
$37.38
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$44.16
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$45.52
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$45.52 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Medicare |
$16.84
|
| Rate for Payer: ASR ASR |
$44.16
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$37.53
|
| Rate for Payer: BCN Commercial |
$37.53
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$44.16
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.52
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$45.52 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Commercial |
$19.63
|
| Rate for Payer: Aetna Commercial |
$26.33
|
| Rate for Payer: Aetna Commercial |
$17.19
|
| Rate for Payer: Aetna Medicare |
$7.07
|
| Rate for Payer: Aetna Medicare |
$16.84
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Aetna Medicare |
$8.07
|
| Rate for Payer: ASR ASR |
$28.38
|
| Rate for Payer: ASR ASR |
$21.16
|
| Rate for Payer: ASR ASR |
$18.53
|
| Rate for Payer: ASR ASR |
$44.16
|
| Rate for Payer: BCBS Complete |
$11.70
|
| Rate for Payer: BCBS Complete |
$7.64
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Trust/PPO |
$17.99
|
| Rate for Payer: BCBS Trust/PPO |
$37.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.12
|
| Rate for Payer: BCBS Trust/PPO |
$15.75
|
| Rate for Payer: BCN Commercial |
$37.53
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: BCN Commercial |
$15.75
|
| Rate for Payer: BCN Commercial |
$17.99
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$17.45
|
| Rate for Payer: Cash Price |
$17.45
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$27.50
|
| Rate for Payer: Cofinity Commercial |
$20.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.40
|
| Rate for Payer: Healthscope Commercial |
$44.16
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Healthscope Commercial |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$28.38
|
| Rate for Payer: Healthscope Whirlpool |
$19.10
|
| Rate for Payer: Healthscope Whirlpool |
$29.25
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Healthscope Whirlpool |
$21.82
|
| Rate for Payer: Mclaren Commercial |
$26.33
|
| Rate for Payer: Mclaren Commercial |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$17.19
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$23.99
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Nomi Health Commercial |
$17.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.20
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$29.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$26.33
|
| Rate for Payer: Aetna Commercial |
$19.63
|
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Commercial |
$17.19
|
| Rate for Payer: ASR ASR |
$44.16
|
| Rate for Payer: ASR ASR |
$28.38
|
| Rate for Payer: ASR ASR |
$21.16
|
| Rate for Payer: ASR ASR |
$18.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.68
|
| Rate for Payer: BCBS Trust/PPO |
$17.92
|
| Rate for Payer: BCBS Trust/PPO |
$37.38
|
| Rate for Payer: BCN Commercial |
$15.68
|
| Rate for Payer: BCN Commercial |
$37.38
|
| Rate for Payer: BCN Commercial |
$17.92
|
| Rate for Payer: BCN Commercial |
$24.02
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$17.45
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$27.50
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$20.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$28.38
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Healthscope Commercial |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$44.16
|
| Rate for Payer: Healthscope Whirlpool |
$29.25
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Healthscope Whirlpool |
$19.10
|
| Rate for Payer: Healthscope Whirlpool |
$21.82
|
| Rate for Payer: Mclaren Commercial |
$17.19
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Mclaren Commercial |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$26.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$17.89
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Nomi Health Commercial |
$23.99
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$17.55
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: ASR ASR |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$14.41
|
| Rate for Payer: BCN Commercial |
$14.41
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$16.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$17.03
|
| Rate for Payer: Healthscope Whirlpool |
$17.55
|
| Rate for Payer: Mclaren Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.92
|
| Rate for Payer: Nomi Health Commercial |
$14.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.45
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$17.55
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Medicare |
$6.49
|
| Rate for Payer: ASR ASR |
$17.03
|
| Rate for Payer: BCBS Complete |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.47
|
| Rate for Payer: BCN Commercial |
$14.47
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$16.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$17.03
|
| Rate for Payer: Healthscope Whirlpool |
$17.55
|
| Rate for Payer: Mclaren Commercial |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.92
|
| Rate for Payer: Nomi Health Commercial |
$14.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.45
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.55
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: ASR ASR |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$14.41
|
| Rate for Payer: BCN Commercial |
$14.41
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$16.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$17.03
|
| Rate for Payer: Healthscope Whirlpool |
$17.55
|
| Rate for Payer: Mclaren Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.92
|
| Rate for Payer: Nomi Health Commercial |
$14.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.45
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.55
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Medicare |
$6.49
|
| Rate for Payer: ASR ASR |
$17.03
|
| Rate for Payer: BCBS Complete |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.47
|
| Rate for Payer: BCN Commercial |
$14.47
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cash Price |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$16.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$17.03
|
| Rate for Payer: Healthscope Whirlpool |
$17.55
|
| Rate for Payer: Mclaren Commercial |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.92
|
| Rate for Payer: Nomi Health Commercial |
$14.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.40
|
| Rate for Payer: Priority Health Narrow Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.45
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$2.30
|
|
|
Service Code
|
NDC 60687015511
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$2.30 |
| Rate for Payer: Aetna Commercial |
$2.07
|
| Rate for Payer: ASR ASR |
$2.23
|
| Rate for Payer: BCBS Trust/PPO |
$1.89
|
| Rate for Payer: BCN Commercial |
$1.89
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.84
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Healthscope Whirlpool |
$2.30
|
| Rate for Payer: Mclaren Commercial |
$2.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.96
|
| Rate for Payer: Nomi Health Commercial |
$1.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.03
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$230.30
|
|
|
Service Code
|
NDC 60687015501
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.72 |
| Max. Negotiated Rate |
$230.30 |
| Rate for Payer: Aetna Commercial |
$207.27
|
| Rate for Payer: ASR ASR |
$223.39
|
| Rate for Payer: BCBS Trust/PPO |
$189.12
|
| Rate for Payer: BCN Commercial |
$189.12
|
| Rate for Payer: Cash Price |
$184.24
|
| Rate for Payer: Cofinity Commercial |
$216.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.24
|
| Rate for Payer: Healthscope Commercial |
$223.39
|
| Rate for Payer: Healthscope Whirlpool |
$230.30
|
| Rate for Payer: Mclaren Commercial |
$207.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.75
|
| Rate for Payer: Nomi Health Commercial |
$188.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.66
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$2.30
|
|
|
Service Code
|
NDC 60687015511
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$2.30 |
| Rate for Payer: Aetna Commercial |
$2.07
|
| Rate for Payer: Aetna Medicare |
$0.85
|
| Rate for Payer: ASR ASR |
$2.23
|
| Rate for Payer: BCBS Complete |
$0.92
|
| Rate for Payer: BCBS Trust/PPO |
$1.90
|
| Rate for Payer: BCN Commercial |
$1.90
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.84
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Healthscope Whirlpool |
$2.30
|
| Rate for Payer: Mclaren Commercial |
$2.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.96
|
| Rate for Payer: Nomi Health Commercial |
$1.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.02
|
| Rate for Payer: Priority Health Narrow Network |
$1.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.03
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$230.30
|
|
|
Service Code
|
NDC 60687015501
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.21 |
| Max. Negotiated Rate |
$230.30 |
| Rate for Payer: Aetna Commercial |
$207.27
|
| Rate for Payer: Aetna Medicare |
$85.21
|
| Rate for Payer: ASR ASR |
$223.39
|
| Rate for Payer: BCBS Complete |
$92.12
|
| Rate for Payer: BCBS Trust/PPO |
$189.88
|
| Rate for Payer: BCN Commercial |
$189.88
|
| Rate for Payer: Cash Price |
$184.24
|
| Rate for Payer: Cofinity Commercial |
$216.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.24
|
| Rate for Payer: Healthscope Commercial |
$223.39
|
| Rate for Payer: Healthscope Whirlpool |
$230.30
|
| Rate for Payer: Mclaren Commercial |
$207.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.75
|
| Rate for Payer: Nomi Health Commercial |
$188.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$201.79
|
| Rate for Payer: Priority Health Narrow Network |
$161.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.66
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$376.00
|
|
|
Service Code
|
NDC 67877015905
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.12 |
| Max. Negotiated Rate |
$376.00 |
| Rate for Payer: Aetna Commercial |
$338.40
|
| Rate for Payer: Aetna Medicare |
$139.12
|
| Rate for Payer: ASR ASR |
$364.72
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: BCBS Trust/PPO |
$310.01
|
| Rate for Payer: BCN Commercial |
$310.01
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$353.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.80
|
| Rate for Payer: Healthscope Commercial |
$364.72
|
| Rate for Payer: Healthscope Whirlpool |
$376.00
|
| Rate for Payer: Mclaren Commercial |
$338.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.60
|
| Rate for Payer: Nomi Health Commercial |
$308.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$329.45
|
| Rate for Payer: Priority Health Narrow Network |
$263.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.88
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$376.00
|
|
|
Service Code
|
NDC 67877015905
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$282.00 |
| Max. Negotiated Rate |
$376.00 |
| Rate for Payer: Aetna Commercial |
$338.40
|
| Rate for Payer: ASR ASR |
$364.72
|
| Rate for Payer: BCBS Trust/PPO |
$308.77
|
| Rate for Payer: BCN Commercial |
$308.77
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$353.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.80
|
| Rate for Payer: Healthscope Commercial |
$364.72
|
| Rate for Payer: Healthscope Whirlpool |
$376.00
|
| Rate for Payer: Mclaren Commercial |
$338.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.60
|
| Rate for Payer: Nomi Health Commercial |
$308.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.88
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$183.35
|
|
|
Service Code
|
NDC 50268055115
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.84 |
| Max. Negotiated Rate |
$183.35 |
| Rate for Payer: Aetna Commercial |
$165.01
|
| Rate for Payer: Aetna Medicare |
$67.84
|
| Rate for Payer: ASR ASR |
$177.85
|
| Rate for Payer: BCBS Complete |
$73.34
|
| Rate for Payer: BCBS Trust/PPO |
$151.17
|
| Rate for Payer: BCN Commercial |
$151.17
|
| Rate for Payer: Cash Price |
$146.68
|
| Rate for Payer: Cofinity Commercial |
$172.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.68
|
| Rate for Payer: Healthscope Commercial |
$177.85
|
| Rate for Payer: Healthscope Whirlpool |
$183.35
|
| Rate for Payer: Mclaren Commercial |
$165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.85
|
| Rate for Payer: Nomi Health Commercial |
$150.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health Narrow Network |
$128.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.35
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$143.35
|
|
|
Service Code
|
NDC 67877041401
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.51 |
| Max. Negotiated Rate |
$143.35 |
| Rate for Payer: Aetna Commercial |
$129.01
|
| Rate for Payer: ASR ASR |
$139.05
|
| Rate for Payer: BCBS Trust/PPO |
$117.72
|
| Rate for Payer: BCN Commercial |
$117.72
|
| Rate for Payer: Cash Price |
$114.68
|
| Rate for Payer: Cofinity Commercial |
$134.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.68
|
| Rate for Payer: Healthscope Commercial |
$139.05
|
| Rate for Payer: Healthscope Whirlpool |
$143.35
|
| Rate for Payer: Mclaren Commercial |
$129.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.85
|
| Rate for Payer: Nomi Health Commercial |
$117.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.15
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$183.35
|
|
|
Service Code
|
NDC 50268055115
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.51 |
| Max. Negotiated Rate |
$183.35 |
| Rate for Payer: Aetna Commercial |
$165.01
|
| Rate for Payer: ASR ASR |
$177.85
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$150.57
|
| Rate for Payer: Cash Price |
$146.68
|
| Rate for Payer: Cofinity Commercial |
$172.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.68
|
| Rate for Payer: Healthscope Commercial |
$177.85
|
| Rate for Payer: Healthscope Whirlpool |
$183.35
|
| Rate for Payer: Mclaren Commercial |
$165.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.85
|
| Rate for Payer: Nomi Health Commercial |
$150.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.35
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$3.67
|
|
|
Service Code
|
NDC 50268055111
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$3.67 |
| Rate for Payer: Aetna Commercial |
$3.30
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: ASR ASR |
$3.56
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS Trust/PPO |
$3.02
|
| Rate for Payer: BCN Commercial |
$3.02
|
| Rate for Payer: Cash Price |
$2.93
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.93
|
| Rate for Payer: Healthscope Commercial |
$3.56
|
| Rate for Payer: Healthscope Whirlpool |
$3.67
|
| Rate for Payer: Mclaren Commercial |
$3.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: Nomi Health Commercial |
$3.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.21
|
| Rate for Payer: Priority Health Narrow Network |
$2.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.23
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$3.67
|
|
|
Service Code
|
NDC 50268055111
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$3.67 |
| Rate for Payer: Aetna Commercial |
$3.30
|
| Rate for Payer: ASR ASR |
$3.56
|
| Rate for Payer: BCBS Trust/PPO |
$3.01
|
| Rate for Payer: BCN Commercial |
$3.01
|
| Rate for Payer: Cash Price |
$2.93
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.93
|
| Rate for Payer: Healthscope Commercial |
$3.56
|
| Rate for Payer: Healthscope Whirlpool |
$3.67
|
| Rate for Payer: Mclaren Commercial |
$3.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: Nomi Health Commercial |
$3.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.23
|
|
|
METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$143.35
|
|
|
Service Code
|
NDC 67877041401
|
| Hospital Charge Code |
35771
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$143.35 |
| Rate for Payer: Aetna Commercial |
$129.01
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: ASR ASR |
$139.05
|
| Rate for Payer: BCBS Complete |
$57.34
|
| Rate for Payer: BCBS Trust/PPO |
$118.19
|
| Rate for Payer: BCN Commercial |
$118.19
|
| Rate for Payer: Cash Price |
$114.68
|
| Rate for Payer: Cofinity Commercial |
$134.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.68
|
| Rate for Payer: Healthscope Commercial |
$139.05
|
| Rate for Payer: Healthscope Whirlpool |
$143.35
|
| Rate for Payer: Mclaren Commercial |
$129.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.85
|
| Rate for Payer: Nomi Health Commercial |
$117.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$125.60
|
| Rate for Payer: Priority Health Narrow Network |
$100.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.15
|
|
|
METHACHOLINE 0.0625 MG/ML (VIAL E) SOLUTION FOR INHALATION
|
Facility
|
IP
|
$170.19
|
|
|
Service Code
|
HCPCS J7674
|
| Hospital Charge Code |
180308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.64 |
| Max. Negotiated Rate |
$170.19 |
| Rate for Payer: Aetna Commercial |
$153.17
|
| Rate for Payer: ASR ASR |
$165.09
|
| Rate for Payer: BCBS Trust/PPO |
$139.76
|
| Rate for Payer: BCN Commercial |
$139.76
|
| Rate for Payer: Cash Price |
$136.15
|
| Rate for Payer: Cofinity Commercial |
$159.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.15
|
| Rate for Payer: Healthscope Commercial |
$165.09
|
| Rate for Payer: Healthscope Whirlpool |
$170.19
|
| Rate for Payer: Mclaren Commercial |
$153.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.66
|
| Rate for Payer: Nomi Health Commercial |
$139.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.77
|
|
|
METHACHOLINE 0.0625 MG/ML (VIAL E) SOLUTION FOR INHALATION
|
Facility
|
OP
|
$170.19
|
|
|
Service Code
|
HCPCS J7674
|
| Hospital Charge Code |
180308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$170.19 |
| Rate for Payer: Aetna Commercial |
$153.17
|
| Rate for Payer: Aetna Medicare |
$62.97
|
| Rate for Payer: ASR ASR |
$165.09
|
| Rate for Payer: BCBS Complete |
$68.08
|
| Rate for Payer: BCBS Trust/PPO |
$140.32
|
| Rate for Payer: BCN Commercial |
$140.32
|
| Rate for Payer: Cash Price |
$136.15
|
| Rate for Payer: Cash Price |
$136.15
|
| Rate for Payer: Cofinity Commercial |
$159.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.15
|
| Rate for Payer: Healthscope Commercial |
$165.09
|
| Rate for Payer: Healthscope Whirlpool |
$170.19
|
| Rate for Payer: Mclaren Commercial |
$153.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.66
|
| Rate for Payer: Nomi Health Commercial |
$139.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.97
|
| Rate for Payer: Priority Health Narrow Network |
$1.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.77
|
|
