|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$14.30
|
|
|
Service Code
|
NDC 09900000346
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$14.30 |
| Rate for Payer: Aetna Commercial |
$12.87
|
| Rate for Payer: ASR ASR |
$13.87
|
| Rate for Payer: ASR Commercial |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$11.65
|
| Rate for Payer: BCN Commercial |
$11.09
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cofinity Commercial |
$13.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$14.30
|
| Rate for Payer: Healthscope Whirlpool |
$13.87
|
| Rate for Payer: Mclaren Commercial |
$12.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Nomi Health Commercial |
$11.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.58
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$40.48
|
|
|
Service Code
|
NDC 60687025240
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$40.48 |
| Rate for Payer: Aetna Commercial |
$36.43
|
| Rate for Payer: Aetna Medicare |
$20.24
|
| Rate for Payer: ASR ASR |
$39.27
|
| Rate for Payer: ASR Commercial |
$39.27
|
| Rate for Payer: BCBS Complete |
$16.19
|
| Rate for Payer: BCBS Trust/PPO |
$33.15
|
| Rate for Payer: BCN Commercial |
$31.38
|
| Rate for Payer: Cash Price |
$32.38
|
| Rate for Payer: Cofinity Commercial |
$38.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.38
|
| Rate for Payer: Healthscope Commercial |
$40.48
|
| Rate for Payer: Healthscope Whirlpool |
$39.27
|
| Rate for Payer: Mclaren Commercial |
$36.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.41
|
| Rate for Payer: Nomi Health Commercial |
$33.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.47
|
| Rate for Payer: Priority Health Narrow Network |
$28.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.62
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
IP
|
$11.65
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Aetna Commercial |
$10.48
|
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$13.88
|
| Rate for Payer: Aetna Commercial |
$9.40
|
| Rate for Payer: ASR ASR |
$9.02
|
| Rate for Payer: ASR ASR |
$16.98
|
| Rate for Payer: ASR ASR |
$14.96
|
| Rate for Payer: ASR ASR |
$11.30
|
| Rate for Payer: ASR ASR |
$10.14
|
| Rate for Payer: ASR Commercial |
$14.96
|
| Rate for Payer: ASR Commercial |
$9.02
|
| Rate for Payer: ASR Commercial |
$16.98
|
| Rate for Payer: ASR Commercial |
$11.30
|
| Rate for Payer: ASR Commercial |
$10.14
|
| Rate for Payer: BCBS Trust/PPO |
$7.58
|
| Rate for Payer: BCBS Trust/PPO |
$8.52
|
| Rate for Payer: BCBS Trust/PPO |
$9.49
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$12.57
|
| Rate for Payer: BCN Commercial |
$9.03
|
| Rate for Payer: BCN Commercial |
$7.21
|
| Rate for Payer: BCN Commercial |
$8.10
|
| Rate for Payer: BCN Commercial |
$11.96
|
| Rate for Payer: BCN Commercial |
$13.57
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Cofinity Commercial |
$16.45
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Healthscope Commercial |
$15.42
|
| Rate for Payer: Healthscope Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Commercial |
$10.45
|
| Rate for Payer: Healthscope Commercial |
$9.30
|
| Rate for Payer: Healthscope Whirlpool |
$9.02
|
| Rate for Payer: Healthscope Whirlpool |
$10.14
|
| Rate for Payer: Healthscope Whirlpool |
$14.96
|
| Rate for Payer: Healthscope Whirlpool |
$11.30
|
| Rate for Payer: Healthscope Whirlpool |
$16.98
|
| Rate for Payer: Mclaren Commercial |
$10.48
|
| Rate for Payer: Mclaren Commercial |
$13.88
|
| Rate for Payer: Mclaren Commercial |
$9.40
|
| Rate for Payer: Mclaren Commercial |
$15.75
|
| Rate for Payer: Mclaren Commercial |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.11
|
| Rate for Payer: Nomi Health Commercial |
$12.64
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Nomi Health Commercial |
$9.55
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.40
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
OP
|
$10.45
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$10.45 |
| Rate for Payer: Aetna Commercial |
$9.40
|
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.88
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna Medicare |
$4.65
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: ASR ASR |
$9.02
|
| Rate for Payer: ASR ASR |
$14.96
|
| Rate for Payer: ASR ASR |
$10.14
|
| Rate for Payer: ASR ASR |
$16.98
|
| Rate for Payer: ASR ASR |
$11.30
|
| Rate for Payer: ASR Commercial |
$9.02
|
| Rate for Payer: ASR Commercial |
$11.30
|
| Rate for Payer: ASR Commercial |
$14.96
|
| Rate for Payer: ASR Commercial |
$16.98
|
| Rate for Payer: ASR Commercial |
$10.14
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS Trust/PPO |
$14.33
|
| Rate for Payer: BCBS Trust/PPO |
$8.56
|
| Rate for Payer: BCBS Trust/PPO |
$9.54
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$7.62
|
| Rate for Payer: BCN Commercial |
$7.21
|
| Rate for Payer: BCN Commercial |
$13.57
|
| Rate for Payer: BCN Commercial |
$9.03
|
| Rate for Payer: BCN Commercial |
$8.10
|
| Rate for Payer: BCN Commercial |
$11.96
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$16.45
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Healthscope Commercial |
$15.42
|
| Rate for Payer: Healthscope Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$10.45
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Whirlpool |
$16.98
|
| Rate for Payer: Healthscope Whirlpool |
$14.96
|
| Rate for Payer: Healthscope Whirlpool |
$11.30
|
| Rate for Payer: Healthscope Whirlpool |
$10.14
|
| Rate for Payer: Healthscope Whirlpool |
$9.02
|
| Rate for Payer: Mclaren Commercial |
$8.37
|
| Rate for Payer: Mclaren Commercial |
$13.88
|
| Rate for Payer: Mclaren Commercial |
$10.48
|
| Rate for Payer: Mclaren Commercial |
$15.75
|
| Rate for Payer: Mclaren Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Nomi Health Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$12.64
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Nomi Health Commercial |
$9.55
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.15
|
| Rate for Payer: Priority Health Narrow Network |
$6.52
|
| Rate for Payer: Priority Health Narrow Network |
$12.27
|
| Rate for Payer: Priority Health Narrow Network |
$8.17
|
| Rate for Payer: Priority Health Narrow Network |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.57
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
IP
|
$11.65
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Aetna Commercial |
$10.48
|
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: Aetna Commercial |
$9.63
|
| Rate for Payer: Aetna Commercial |
$9.40
|
| Rate for Payer: Aetna Commercial |
$9.68
|
| Rate for Payer: Aetna Commercial |
$13.88
|
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Commercial |
$13.68
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$8.78
|
| Rate for Payer: ASR ASR |
$10.48
|
| Rate for Payer: ASR ASR |
$9.46
|
| Rate for Payer: ASR ASR |
$10.43
|
| Rate for Payer: ASR ASR |
$11.30
|
| Rate for Payer: ASR ASR |
$14.96
|
| Rate for Payer: ASR ASR |
$14.74
|
| Rate for Payer: ASR ASR |
$9.02
|
| Rate for Payer: ASR ASR |
$16.76
|
| Rate for Payer: ASR ASR |
$10.38
|
| Rate for Payer: ASR ASR |
$10.14
|
| Rate for Payer: ASR ASR |
$16.98
|
| Rate for Payer: ASR Commercial |
$10.43
|
| Rate for Payer: ASR Commercial |
$10.48
|
| Rate for Payer: ASR Commercial |
$10.38
|
| Rate for Payer: ASR Commercial |
$10.14
|
| Rate for Payer: ASR Commercial |
$14.96
|
| Rate for Payer: ASR Commercial |
$16.76
|
| Rate for Payer: ASR Commercial |
$9.02
|
| Rate for Payer: ASR Commercial |
$16.98
|
| Rate for Payer: ASR Commercial |
$9.46
|
| Rate for Payer: ASR Commercial |
$14.74
|
| Rate for Payer: ASR Commercial |
$11.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$14.08
|
| Rate for Payer: BCBS Trust/PPO |
$9.49
|
| Rate for Payer: BCBS Trust/PPO |
$8.52
|
| Rate for Payer: BCBS Trust/PPO |
$8.72
|
| Rate for Payer: BCBS Trust/PPO |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$8.76
|
| Rate for Payer: BCBS Trust/PPO |
$7.95
|
| Rate for Payer: BCBS Trust/PPO |
$7.58
|
| Rate for Payer: BCBS Trust/PPO |
$12.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.57
|
| Rate for Payer: BCN Commercial |
$9.03
|
| Rate for Payer: BCN Commercial |
$11.78
|
| Rate for Payer: BCN Commercial |
$8.37
|
| Rate for Payer: BCN Commercial |
$8.10
|
| Rate for Payer: BCN Commercial |
$13.57
|
| Rate for Payer: BCN Commercial |
$8.30
|
| Rate for Payer: BCN Commercial |
$8.33
|
| Rate for Payer: BCN Commercial |
$11.96
|
| Rate for Payer: BCN Commercial |
$7.21
|
| Rate for Payer: BCN Commercial |
$7.56
|
| Rate for Payer: BCN Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$12.16
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$9.16
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$10.15
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$16.45
|
| Rate for Payer: Cofinity Commercial |
$14.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Healthscope Commercial |
$17.28
|
| Rate for Payer: Healthscope Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$10.75
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Healthscope Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Commercial |
$15.42
|
| Rate for Payer: Healthscope Commercial |
$9.75
|
| Rate for Payer: Healthscope Commercial |
$10.45
|
| Rate for Payer: Healthscope Commercial |
$10.70
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Healthscope Whirlpool |
$9.02
|
| Rate for Payer: Healthscope Whirlpool |
$10.14
|
| Rate for Payer: Healthscope Whirlpool |
$10.43
|
| Rate for Payer: Healthscope Whirlpool |
$10.38
|
| Rate for Payer: Healthscope Whirlpool |
$10.48
|
| Rate for Payer: Healthscope Whirlpool |
$11.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.74
|
| Rate for Payer: Healthscope Whirlpool |
$14.96
|
| Rate for Payer: Healthscope Whirlpool |
$16.76
|
| Rate for Payer: Healthscope Whirlpool |
$16.98
|
| Rate for Payer: Healthscope Whirlpool |
$9.46
|
| Rate for Payer: Mclaren Commercial |
$8.78
|
| Rate for Payer: Mclaren Commercial |
$13.68
|
| Rate for Payer: Mclaren Commercial |
$10.48
|
| Rate for Payer: Mclaren Commercial |
$9.63
|
| Rate for Payer: Mclaren Commercial |
$9.68
|
| Rate for Payer: Mclaren Commercial |
$15.55
|
| Rate for Payer: Mclaren Commercial |
$13.88
|
| Rate for Payer: Mclaren Commercial |
$9.40
|
| Rate for Payer: Mclaren Commercial |
$9.72
|
| Rate for Payer: Mclaren Commercial |
$8.37
|
| Rate for Payer: Mclaren Commercial |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.29
|
| Rate for Payer: Nomi Health Commercial |
$8.86
|
| Rate for Payer: Nomi Health Commercial |
$8.81
|
| Rate for Payer: Nomi Health Commercial |
$14.17
|
| Rate for Payer: Nomi Health Commercial |
$12.64
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$8.77
|
| Rate for Payer: Nomi Health Commercial |
$12.46
|
| Rate for Payer: Nomi Health Commercial |
$8.00
|
| Rate for Payer: Nomi Health Commercial |
$9.55
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.57
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
OP
|
$11.65
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Aetna Commercial |
$10.48
|
| Rate for Payer: Aetna Commercial |
$13.88
|
| Rate for Payer: Aetna Commercial |
$9.63
|
| Rate for Payer: Aetna Commercial |
$13.68
|
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: Aetna Commercial |
$9.40
|
| Rate for Payer: Aetna Commercial |
$8.78
|
| Rate for Payer: Aetna Commercial |
$9.68
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Aetna Medicare |
$5.35
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: Aetna Medicare |
$4.88
|
| Rate for Payer: Aetna Medicare |
$5.40
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Aetna Medicare |
$8.64
|
| Rate for Payer: Aetna Medicare |
$5.38
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: Aetna Medicare |
$4.65
|
| Rate for Payer: ASR ASR |
$10.48
|
| Rate for Payer: ASR ASR |
$10.43
|
| Rate for Payer: ASR ASR |
$16.76
|
| Rate for Payer: ASR ASR |
$9.46
|
| Rate for Payer: ASR ASR |
$14.74
|
| Rate for Payer: ASR ASR |
$10.14
|
| Rate for Payer: ASR ASR |
$14.96
|
| Rate for Payer: ASR ASR |
$9.02
|
| Rate for Payer: ASR ASR |
$11.30
|
| Rate for Payer: ASR ASR |
$16.98
|
| Rate for Payer: ASR ASR |
$10.38
|
| Rate for Payer: ASR Commercial |
$14.74
|
| Rate for Payer: ASR Commercial |
$10.38
|
| Rate for Payer: ASR Commercial |
$10.43
|
| Rate for Payer: ASR Commercial |
$10.48
|
| Rate for Payer: ASR Commercial |
$10.14
|
| Rate for Payer: ASR Commercial |
$9.46
|
| Rate for Payer: ASR Commercial |
$9.02
|
| Rate for Payer: ASR Commercial |
$16.98
|
| Rate for Payer: ASR Commercial |
$16.76
|
| Rate for Payer: ASR Commercial |
$11.30
|
| Rate for Payer: ASR Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$6.91
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS Complete |
$3.90
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS Complete |
$6.08
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS Complete |
$4.30
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS Complete |
$4.28
|
| Rate for Payer: BCBS Trust/PPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$7.62
|
| Rate for Payer: BCBS Trust/PPO |
$14.33
|
| Rate for Payer: BCBS Trust/PPO |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$8.76
|
| Rate for Payer: BCBS Trust/PPO |
$8.56
|
| Rate for Payer: BCBS Trust/PPO |
$12.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.54
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$7.98
|
| Rate for Payer: BCN Commercial |
$8.30
|
| Rate for Payer: BCN Commercial |
$13.40
|
| Rate for Payer: BCN Commercial |
$11.78
|
| Rate for Payer: BCN Commercial |
$8.37
|
| Rate for Payer: BCN Commercial |
$7.56
|
| Rate for Payer: BCN Commercial |
$9.03
|
| Rate for Payer: BCN Commercial |
$11.96
|
| Rate for Payer: BCN Commercial |
$13.57
|
| Rate for Payer: BCN Commercial |
$7.21
|
| Rate for Payer: BCN Commercial |
$8.33
|
| Rate for Payer: BCN Commercial |
$8.10
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$12.16
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$14.00
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$10.15
|
| Rate for Payer: Cofinity Commercial |
$9.16
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$16.45
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$14.29
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$10.75
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Commercial |
$17.28
|
| Rate for Payer: Healthscope Commercial |
$15.42
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Healthscope Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$10.45
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$10.70
|
| Rate for Payer: Healthscope Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$9.75
|
| Rate for Payer: Healthscope Whirlpool |
$9.46
|
| Rate for Payer: Healthscope Whirlpool |
$9.02
|
| Rate for Payer: Healthscope Whirlpool |
$10.14
|
| Rate for Payer: Healthscope Whirlpool |
$10.38
|
| Rate for Payer: Healthscope Whirlpool |
$10.43
|
| Rate for Payer: Healthscope Whirlpool |
$16.76
|
| Rate for Payer: Healthscope Whirlpool |
$16.98
|
| Rate for Payer: Healthscope Whirlpool |
$11.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.96
|
| Rate for Payer: Healthscope Whirlpool |
$14.74
|
| Rate for Payer: Healthscope Whirlpool |
$10.48
|
| Rate for Payer: Mclaren Commercial |
$15.75
|
| Rate for Payer: Mclaren Commercial |
$10.48
|
| Rate for Payer: Mclaren Commercial |
$13.88
|
| Rate for Payer: Mclaren Commercial |
$8.78
|
| Rate for Payer: Mclaren Commercial |
$13.68
|
| Rate for Payer: Mclaren Commercial |
$9.72
|
| Rate for Payer: Mclaren Commercial |
$15.55
|
| Rate for Payer: Mclaren Commercial |
$9.40
|
| Rate for Payer: Mclaren Commercial |
$9.63
|
| Rate for Payer: Mclaren Commercial |
$9.68
|
| Rate for Payer: Mclaren Commercial |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.11
|
| Rate for Payer: Nomi Health Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$8.81
|
| Rate for Payer: Nomi Health Commercial |
$14.17
|
| Rate for Payer: Nomi Health Commercial |
$9.55
|
| Rate for Payer: Nomi Health Commercial |
$12.46
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Nomi Health Commercial |
$8.00
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$8.77
|
| Rate for Payer: Nomi Health Commercial |
$8.86
|
| Rate for Payer: Nomi Health Commercial |
$12.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.46
|
| Rate for Payer: Priority Health Narrow Network |
$12.11
|
| Rate for Payer: Priority Health Narrow Network |
$7.54
|
| Rate for Payer: Priority Health Narrow Network |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$10.81
|
| Rate for Payer: Priority Health Narrow Network |
$6.52
|
| Rate for Payer: Priority Health Narrow Network |
$6.83
|
| Rate for Payer: Priority Health Narrow Network |
$8.17
|
| Rate for Payer: Priority Health Narrow Network |
$7.50
|
| Rate for Payer: Priority Health Narrow Network |
$7.57
|
| Rate for Payer: Priority Health Narrow Network |
$10.66
|
| Rate for Payer: Priority Health Narrow Network |
$12.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.38
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$45.52
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.21 |
| Max. Negotiated Rate |
$45.52 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Commercial |
$55.43
|
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: Aetna Commercial |
$55.11
|
| Rate for Payer: Aetna Medicare |
$30.80
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: Aetna Medicare |
$30.61
|
| Rate for Payer: Aetna Medicare |
$22.02
|
| Rate for Payer: ASR ASR |
$59.39
|
| Rate for Payer: ASR ASR |
$42.73
|
| Rate for Payer: ASR ASR |
$59.74
|
| Rate for Payer: ASR ASR |
$44.15
|
| Rate for Payer: ASR Commercial |
$44.15
|
| Rate for Payer: ASR Commercial |
$59.39
|
| Rate for Payer: ASR Commercial |
$59.74
|
| Rate for Payer: ASR Commercial |
$42.73
|
| Rate for Payer: BCBS Complete |
$17.62
|
| Rate for Payer: BCBS Complete |
$24.64
|
| Rate for Payer: BCBS Complete |
$24.49
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$37.28
|
| Rate for Payer: BCBS Trust/PPO |
$50.44
|
| Rate for Payer: BCBS Trust/PPO |
$36.07
|
| Rate for Payer: BCBS Trust/PPO |
$50.14
|
| Rate for Payer: BCN Commercial |
$47.75
|
| Rate for Payer: BCN Commercial |
$35.29
|
| Rate for Payer: BCN Commercial |
$34.15
|
| Rate for Payer: BCN Commercial |
$47.47
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$35.24
|
| Rate for Payer: Cash Price |
$48.99
|
| Rate for Payer: Cash Price |
$49.27
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$57.56
|
| Rate for Payer: Cofinity Commercial |
$57.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$61.23
|
| Rate for Payer: Healthscope Commercial |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$45.52
|
| Rate for Payer: Healthscope Commercial |
$61.59
|
| Rate for Payer: Healthscope Whirlpool |
$59.74
|
| Rate for Payer: Healthscope Whirlpool |
$59.39
|
| Rate for Payer: Healthscope Whirlpool |
$44.15
|
| Rate for Payer: Healthscope Whirlpool |
$42.73
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Mclaren Commercial |
$55.11
|
| Rate for Payer: Mclaren Commercial |
$55.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.05
|
| Rate for Payer: Nomi Health Commercial |
$50.21
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Nomi Health Commercial |
$50.50
|
| Rate for Payer: Nomi Health Commercial |
$36.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.60
|
| Rate for Payer: Priority Health Narrow Network |
$42.92
|
| Rate for Payer: Priority Health Narrow Network |
$31.91
|
| Rate for Payer: Priority Health Narrow Network |
$43.17
|
| Rate for Payer: Priority Health Narrow Network |
$30.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$61.23
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$61.23 |
| Rate for Payer: Aetna Commercial |
$55.11
|
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Commercial |
$55.43
|
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: ASR ASR |
$42.73
|
| Rate for Payer: ASR ASR |
$59.39
|
| Rate for Payer: ASR ASR |
$44.15
|
| Rate for Payer: ASR ASR |
$59.74
|
| Rate for Payer: ASR Commercial |
$59.39
|
| Rate for Payer: ASR Commercial |
$59.74
|
| Rate for Payer: ASR Commercial |
$44.15
|
| Rate for Payer: ASR Commercial |
$42.73
|
| Rate for Payer: BCBS Trust/PPO |
$50.19
|
| Rate for Payer: BCBS Trust/PPO |
$35.90
|
| Rate for Payer: BCBS Trust/PPO |
$37.09
|
| Rate for Payer: BCBS Trust/PPO |
$49.90
|
| Rate for Payer: BCN Commercial |
$47.75
|
| Rate for Payer: BCN Commercial |
$34.15
|
| Rate for Payer: BCN Commercial |
$47.47
|
| Rate for Payer: BCN Commercial |
$35.29
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$35.24
|
| Rate for Payer: Cash Price |
$49.27
|
| Rate for Payer: Cash Price |
$48.99
|
| Rate for Payer: Cofinity Commercial |
$57.56
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$57.89
|
| Rate for Payer: Cofinity Commercial |
$41.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.98
|
| Rate for Payer: Healthscope Commercial |
$45.52
|
| Rate for Payer: Healthscope Commercial |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$61.23
|
| Rate for Payer: Healthscope Commercial |
$61.59
|
| Rate for Payer: Healthscope Whirlpool |
$59.74
|
| Rate for Payer: Healthscope Whirlpool |
$44.15
|
| Rate for Payer: Healthscope Whirlpool |
$59.39
|
| Rate for Payer: Healthscope Whirlpool |
$42.73
|
| Rate for Payer: Mclaren Commercial |
$55.11
|
| Rate for Payer: Mclaren Commercial |
$55.43
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.44
|
| Rate for Payer: Nomi Health Commercial |
$36.12
|
| Rate for Payer: Nomi Health Commercial |
$50.50
|
| Rate for Payer: Nomi Health Commercial |
$50.21
|
| Rate for Payer: Nomi Health Commercial |
$37.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.76
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$209.33 |
| Max. Negotiated Rate |
$322.05 |
| Rate for Payer: Aetna Commercial |
$289.85
|
| Rate for Payer: ASR ASR |
$312.39
|
| Rate for Payer: ASR Commercial |
$312.39
|
| Rate for Payer: BCBS Trust/PPO |
$262.44
|
| Rate for Payer: BCN Commercial |
$249.69
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$302.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.64
|
| Rate for Payer: Healthscope Commercial |
$322.05
|
| Rate for Payer: Healthscope Whirlpool |
$312.39
|
| Rate for Payer: Mclaren Commercial |
$289.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: Nomi Health Commercial |
$264.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.40
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$479.48
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$311.66 |
| Max. Negotiated Rate |
$479.48 |
| Rate for Payer: Aetna Commercial |
$431.53
|
| Rate for Payer: ASR ASR |
$465.10
|
| Rate for Payer: ASR Commercial |
$465.10
|
| Rate for Payer: BCBS Trust/PPO |
$390.73
|
| Rate for Payer: BCN Commercial |
$371.74
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$450.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.58
|
| Rate for Payer: Healthscope Commercial |
$479.48
|
| Rate for Payer: Healthscope Whirlpool |
$465.10
|
| Rate for Payer: Mclaren Commercial |
$431.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.56
|
| Rate for Payer: Nomi Health Commercial |
$393.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.94
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$39.17 |
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: ASR ASR |
$37.99
|
| Rate for Payer: ASR Commercial |
$37.99
|
| Rate for Payer: BCBS Trust/PPO |
$31.92
|
| Rate for Payer: BCN Commercial |
$30.37
|
| Rate for Payer: Cash Price |
$31.33
|
| Rate for Payer: Cofinity Commercial |
$36.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$39.17
|
| Rate for Payer: Healthscope Whirlpool |
$37.99
|
| Rate for Payer: Mclaren Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.47
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$39.17 |
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna Medicare |
$19.59
|
| Rate for Payer: ASR ASR |
$37.99
|
| Rate for Payer: ASR Commercial |
$37.99
|
| Rate for Payer: BCBS Complete |
$15.67
|
| Rate for Payer: BCBS Trust/PPO |
$32.08
|
| Rate for Payer: BCN Commercial |
$30.37
|
| Rate for Payer: Cash Price |
$31.33
|
| Rate for Payer: Cofinity Commercial |
$36.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$39.17
|
| Rate for Payer: Healthscope Whirlpool |
$37.99
|
| Rate for Payer: Mclaren Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.32
|
| Rate for Payer: Priority Health Narrow Network |
$27.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.47
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$322.05
|
|
|
Service Code
|
NDC 47781046813
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.82 |
| Max. Negotiated Rate |
$322.05 |
| Rate for Payer: Aetna Commercial |
$289.85
|
| Rate for Payer: Aetna Medicare |
$161.03
|
| Rate for Payer: ASR ASR |
$312.39
|
| Rate for Payer: ASR Commercial |
$312.39
|
| Rate for Payer: BCBS Complete |
$128.82
|
| Rate for Payer: BCBS Trust/PPO |
$263.73
|
| Rate for Payer: BCN Commercial |
$249.69
|
| Rate for Payer: Cash Price |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$302.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.64
|
| Rate for Payer: Healthscope Commercial |
$322.05
|
| Rate for Payer: Healthscope Whirlpool |
$312.39
|
| Rate for Payer: Mclaren Commercial |
$289.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.74
|
| Rate for Payer: Nomi Health Commercial |
$264.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.18
|
| Rate for Payer: Priority Health Narrow Network |
$225.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.40
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$479.48
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.79 |
| Max. Negotiated Rate |
$479.48 |
| Rate for Payer: Aetna Commercial |
$431.53
|
| Rate for Payer: Aetna Medicare |
$239.74
|
| Rate for Payer: ASR ASR |
$465.10
|
| Rate for Payer: ASR Commercial |
$465.10
|
| Rate for Payer: BCBS Complete |
$191.79
|
| Rate for Payer: BCBS Trust/PPO |
$392.65
|
| Rate for Payer: BCN Commercial |
$371.74
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$450.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.58
|
| Rate for Payer: Healthscope Commercial |
$479.48
|
| Rate for Payer: Healthscope Whirlpool |
$465.10
|
| Rate for Payer: Mclaren Commercial |
$431.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.56
|
| Rate for Payer: Nomi Health Commercial |
$393.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$420.12
|
| Rate for Payer: Priority Health Narrow Network |
$336.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.34 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$207.76
|
| Rate for Payer: Aetna Medicare |
$115.42
|
| Rate for Payer: ASR ASR |
$223.92
|
| Rate for Payer: ASR Commercial |
$223.92
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS Trust/PPO |
$189.04
|
| Rate for Payer: BCN Commercial |
$178.98
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Healthscope Whirlpool |
$223.92
|
| Rate for Payer: Mclaren Commercial |
$207.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: Nomi Health Commercial |
$189.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.27
|
| Rate for Payer: Priority Health Narrow Network |
$161.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.15
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$447.55
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$179.02 |
| Max. Negotiated Rate |
$447.55 |
| Rate for Payer: Aetna Commercial |
$402.80
|
| Rate for Payer: Aetna Medicare |
$223.78
|
| Rate for Payer: ASR ASR |
$434.12
|
| Rate for Payer: ASR Commercial |
$434.12
|
| Rate for Payer: BCBS Complete |
$179.02
|
| Rate for Payer: BCBS Trust/PPO |
$366.50
|
| Rate for Payer: BCN Commercial |
$346.99
|
| Rate for Payer: Cash Price |
$358.04
|
| Rate for Payer: Cofinity Commercial |
$420.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.04
|
| Rate for Payer: Healthscope Commercial |
$447.55
|
| Rate for Payer: Healthscope Whirlpool |
$434.12
|
| Rate for Payer: Mclaren Commercial |
$402.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.42
|
| Rate for Payer: Nomi Health Commercial |
$366.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.14
|
| Rate for Payer: Priority Health Narrow Network |
$313.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.84
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$230.85
|
|
|
Service Code
|
NDC 68180067801
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.05 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$207.76
|
| Rate for Payer: ASR ASR |
$223.92
|
| Rate for Payer: ASR Commercial |
$223.92
|
| Rate for Payer: BCBS Trust/PPO |
$188.12
|
| Rate for Payer: BCN Commercial |
$178.98
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Healthscope Whirlpool |
$223.92
|
| Rate for Payer: Mclaren Commercial |
$207.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.22
|
| Rate for Payer: Nomi Health Commercial |
$189.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.15
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$339.68 |
| Max. Negotiated Rate |
$522.59 |
| Rate for Payer: Aetna Commercial |
$470.33
|
| Rate for Payer: ASR ASR |
$506.91
|
| Rate for Payer: ASR Commercial |
$506.91
|
| Rate for Payer: BCBS Trust/PPO |
$425.86
|
| Rate for Payer: BCN Commercial |
$405.16
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Commercial |
$491.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$522.59
|
| Rate for Payer: Healthscope Whirlpool |
$506.91
|
| Rate for Payer: Mclaren Commercial |
$470.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Nomi Health Commercial |
$428.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$459.88
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$447.55
|
|
|
Service Code
|
NDC 47781038426
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$290.91 |
| Max. Negotiated Rate |
$447.55 |
| Rate for Payer: Aetna Commercial |
$402.80
|
| Rate for Payer: ASR ASR |
$434.12
|
| Rate for Payer: ASR Commercial |
$434.12
|
| Rate for Payer: BCBS Trust/PPO |
$364.71
|
| Rate for Payer: BCN Commercial |
$346.99
|
| Rate for Payer: Cash Price |
$358.04
|
| Rate for Payer: Cofinity Commercial |
$420.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.04
|
| Rate for Payer: Healthscope Commercial |
$447.55
|
| Rate for Payer: Healthscope Whirlpool |
$434.12
|
| Rate for Payer: Mclaren Commercial |
$402.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.42
|
| Rate for Payer: Nomi Health Commercial |
$366.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.84
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$522.59 |
| Rate for Payer: Aetna Commercial |
$470.33
|
| Rate for Payer: Aetna Medicare |
$261.30
|
| Rate for Payer: ASR ASR |
$506.91
|
| Rate for Payer: ASR Commercial |
$506.91
|
| Rate for Payer: BCBS Complete |
$209.04
|
| Rate for Payer: BCBS Trust/PPO |
$427.95
|
| Rate for Payer: BCN Commercial |
$405.16
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Commercial |
$491.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Healthscope Commercial |
$522.59
|
| Rate for Payer: Healthscope Whirlpool |
$506.91
|
| Rate for Payer: Mclaren Commercial |
$470.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Nomi Health Commercial |
$428.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$457.89
|
| Rate for Payer: Priority Health Narrow Network |
$366.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$459.88
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$276.20
|
|
|
Service Code
|
NDC 70710101002
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$276.20 |
| Rate for Payer: Aetna Commercial |
$248.58
|
| Rate for Payer: Aetna Medicare |
$138.10
|
| Rate for Payer: ASR ASR |
$267.91
|
| Rate for Payer: ASR Commercial |
$267.91
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS Trust/PPO |
$226.18
|
| Rate for Payer: BCN Commercial |
$214.14
|
| Rate for Payer: Cash Price |
$220.96
|
| Rate for Payer: Cofinity Commercial |
$259.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.96
|
| Rate for Payer: Healthscope Commercial |
$276.20
|
| Rate for Payer: Healthscope Whirlpool |
$267.91
|
| Rate for Payer: Mclaren Commercial |
$248.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.77
|
| Rate for Payer: Nomi Health Commercial |
$226.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.01
|
| Rate for Payer: Priority Health Narrow Network |
$193.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.06
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
OP
|
$351.02
|
|
|
Service Code
|
NDC 47781047013
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.41 |
| Max. Negotiated Rate |
$351.02 |
| Rate for Payer: Aetna Commercial |
$315.92
|
| Rate for Payer: Aetna Medicare |
$175.51
|
| Rate for Payer: ASR ASR |
$340.49
|
| Rate for Payer: ASR Commercial |
$340.49
|
| Rate for Payer: BCBS Complete |
$140.41
|
| Rate for Payer: BCBS Trust/PPO |
$287.45
|
| Rate for Payer: BCN Commercial |
$272.15
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Commercial |
$329.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Healthscope Commercial |
$351.02
|
| Rate for Payer: Healthscope Whirlpool |
$340.49
|
| Rate for Payer: Mclaren Commercial |
$315.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: Nomi Health Commercial |
$287.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.56
|
| Rate for Payer: Priority Health Narrow Network |
$246.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.90
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$275.24
|
|
|
Service Code
|
NDC 62332041510
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.91 |
| Max. Negotiated Rate |
$275.24 |
| Rate for Payer: Aetna Commercial |
$247.72
|
| Rate for Payer: ASR ASR |
$266.98
|
| Rate for Payer: ASR Commercial |
$266.98
|
| Rate for Payer: BCBS Trust/PPO |
$224.29
|
| Rate for Payer: BCN Commercial |
$213.39
|
| Rate for Payer: Cash Price |
$220.19
|
| Rate for Payer: Cofinity Commercial |
$258.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.19
|
| Rate for Payer: Healthscope Commercial |
$275.24
|
| Rate for Payer: Healthscope Whirlpool |
$266.98
|
| Rate for Payer: Mclaren Commercial |
$247.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.95
|
| Rate for Payer: Nomi Health Commercial |
$225.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.21
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$351.02
|
|
|
Service Code
|
NDC 47781047013
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$228.16 |
| Max. Negotiated Rate |
$351.02 |
| Rate for Payer: Aetna Commercial |
$315.92
|
| Rate for Payer: ASR ASR |
$340.49
|
| Rate for Payer: ASR Commercial |
$340.49
|
| Rate for Payer: BCBS Trust/PPO |
$286.05
|
| Rate for Payer: BCN Commercial |
$272.15
|
| Rate for Payer: Cash Price |
$280.82
|
| Rate for Payer: Cofinity Commercial |
$329.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.82
|
| Rate for Payer: Healthscope Commercial |
$351.02
|
| Rate for Payer: Healthscope Whirlpool |
$340.49
|
| Rate for Payer: Mclaren Commercial |
$315.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.37
|
| Rate for Payer: Nomi Health Commercial |
$287.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.90
|
|
|
OSELTAMIVIR 75 MG CAPSULE
|
Facility
|
IP
|
$522.62
|
|
|
Service Code
|
NDC 00004080085
|
| Hospital Charge Code |
26546
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$339.70 |
| Max. Negotiated Rate |
$522.62 |
| Rate for Payer: Aetna Commercial |
$470.36
|
| Rate for Payer: ASR ASR |
$506.94
|
| Rate for Payer: ASR Commercial |
$506.94
|
| Rate for Payer: BCBS Trust/PPO |
$425.88
|
| Rate for Payer: BCN Commercial |
$405.19
|
| Rate for Payer: Cash Price |
$418.10
|
| Rate for Payer: Cofinity Commercial |
$491.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.10
|
| Rate for Payer: Healthscope Commercial |
$522.62
|
| Rate for Payer: Healthscope Whirlpool |
$506.94
|
| Rate for Payer: Mclaren Commercial |
$470.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.23
|
| Rate for Payer: Nomi Health Commercial |
$428.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$459.91
|
|
