|
PILOCARPINE 2 % EYE DROPS
|
Facility
|
OP
|
$136.71
|
|
|
Service Code
|
NDC 70069019101
|
| Hospital Charge Code |
6280
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.68 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$123.04
|
| Rate for Payer: Aetna Medicare |
$68.36
|
| Rate for Payer: ASR ASR |
$132.61
|
| Rate for Payer: ASR Commercial |
$132.61
|
| Rate for Payer: BCBS Complete |
$54.68
|
| Rate for Payer: BCBS Trust/PPO |
$111.95
|
| Rate for Payer: BCN Commercial |
$105.99
|
| Rate for Payer: Cash Price |
$109.37
|
| Rate for Payer: Cofinity Commercial |
$128.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.37
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Healthscope Whirlpool |
$132.61
|
| Rate for Payer: Mclaren Commercial |
$123.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.20
|
| Rate for Payer: Nomi Health Commercial |
$112.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.79
|
| Rate for Payer: Priority Health Narrow Network |
$95.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.30
|
|
|
PILOCARPINE 2 % EYE DROPS
|
Facility
|
IP
|
$136.71
|
|
|
Service Code
|
NDC 70069019101
|
| Hospital Charge Code |
6280
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.86 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$123.04
|
| Rate for Payer: ASR ASR |
$132.61
|
| Rate for Payer: ASR Commercial |
$132.61
|
| Rate for Payer: BCBS Trust/PPO |
$111.40
|
| Rate for Payer: BCN Commercial |
$105.99
|
| Rate for Payer: Cash Price |
$109.37
|
| Rate for Payer: Cofinity Commercial |
$128.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.37
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Healthscope Whirlpool |
$132.61
|
| Rate for Payer: Mclaren Commercial |
$123.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.20
|
| Rate for Payer: Nomi Health Commercial |
$112.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.30
|
|
|
PILOCARPINE 2 % EYE DROPS
|
Facility
|
OP
|
$136.18
|
|
|
Service Code
|
NDC 61314020415
|
| Hospital Charge Code |
6280
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.47 |
| Max. Negotiated Rate |
$136.18 |
| Rate for Payer: Aetna Commercial |
$122.56
|
| Rate for Payer: Aetna Medicare |
$68.09
|
| Rate for Payer: ASR ASR |
$132.09
|
| Rate for Payer: ASR Commercial |
$132.09
|
| Rate for Payer: BCBS Complete |
$54.47
|
| Rate for Payer: BCBS Trust/PPO |
$111.52
|
| Rate for Payer: BCN Commercial |
$105.58
|
| Rate for Payer: Cash Price |
$108.95
|
| Rate for Payer: Cofinity Commercial |
$128.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.94
|
| Rate for Payer: Healthscope Commercial |
$136.18
|
| Rate for Payer: Healthscope Whirlpool |
$132.09
|
| Rate for Payer: Mclaren Commercial |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.75
|
| Rate for Payer: Nomi Health Commercial |
$111.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.32
|
| Rate for Payer: Priority Health Narrow Network |
$95.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.84
|
|
|
PILOCARPINE 2 % EYE DROPS
|
Facility
|
IP
|
$136.18
|
|
|
Service Code
|
NDC 61314020415
|
| Hospital Charge Code |
6280
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.52 |
| Max. Negotiated Rate |
$136.18 |
| Rate for Payer: Aetna Commercial |
$122.56
|
| Rate for Payer: ASR ASR |
$132.09
|
| Rate for Payer: ASR Commercial |
$132.09
|
| Rate for Payer: BCBS Trust/PPO |
$110.97
|
| Rate for Payer: BCN Commercial |
$105.58
|
| Rate for Payer: Cash Price |
$108.95
|
| Rate for Payer: Cofinity Commercial |
$128.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.94
|
| Rate for Payer: Healthscope Commercial |
$136.18
|
| Rate for Payer: Healthscope Whirlpool |
$132.09
|
| Rate for Payer: Mclaren Commercial |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.75
|
| Rate for Payer: Nomi Health Commercial |
$111.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.84
|
|
|
PILOCARPINE 5 MG TABLET
|
Facility
|
IP
|
$361.00
|
|
|
Service Code
|
NDC 00574079201
|
| Hospital Charge Code |
12803
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna Commercial |
$324.90
|
| Rate for Payer: ASR ASR |
$350.17
|
| Rate for Payer: ASR Commercial |
$350.17
|
| Rate for Payer: BCBS Trust/PPO |
$294.18
|
| Rate for Payer: BCN Commercial |
$279.88
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$339.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.80
|
| Rate for Payer: Healthscope Commercial |
$361.00
|
| Rate for Payer: Healthscope Whirlpool |
$350.17
|
| Rate for Payer: Mclaren Commercial |
$324.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.85
|
| Rate for Payer: Nomi Health Commercial |
$296.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.68
|
|
|
PILOCARPINE 5 MG TABLET
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
NDC 00574079201
|
| Hospital Charge Code |
12803
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.40 |
| Max. Negotiated Rate |
$361.00 |
| Rate for Payer: Aetna Commercial |
$324.90
|
| Rate for Payer: Aetna Medicare |
$180.50
|
| Rate for Payer: ASR ASR |
$350.17
|
| Rate for Payer: ASR Commercial |
$350.17
|
| Rate for Payer: BCBS Complete |
$144.40
|
| Rate for Payer: BCBS Trust/PPO |
$295.62
|
| Rate for Payer: BCN Commercial |
$279.88
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$339.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.80
|
| Rate for Payer: Healthscope Commercial |
$361.00
|
| Rate for Payer: Healthscope Whirlpool |
$350.17
|
| Rate for Payer: Mclaren Commercial |
$324.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.85
|
| Rate for Payer: Nomi Health Commercial |
$296.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.31
|
| Rate for Payer: Priority Health Narrow Network |
$253.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.68
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
IP
|
$1,337.11
|
|
|
Service Code
|
NDC 64764015104
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$869.12 |
| Max. Negotiated Rate |
$1,337.11 |
| Rate for Payer: Aetna Commercial |
$1,203.40
|
| Rate for Payer: ASR ASR |
$1,297.00
|
| Rate for Payer: ASR Commercial |
$1,297.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.61
|
| Rate for Payer: BCN Commercial |
$1,036.66
|
| Rate for Payer: Cash Price |
$1,069.68
|
| Rate for Payer: Cofinity Commercial |
$1,256.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,337.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,297.00
|
| Rate for Payer: Mclaren Commercial |
$1,203.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.54
|
| Rate for Payer: Nomi Health Commercial |
$1,096.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,176.66
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
OP
|
$1,337.11
|
|
|
Service Code
|
NDC 64764015104
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$534.84 |
| Max. Negotiated Rate |
$1,337.11 |
| Rate for Payer: Aetna Commercial |
$1,203.40
|
| Rate for Payer: Aetna Medicare |
$668.55
|
| Rate for Payer: ASR ASR |
$1,297.00
|
| Rate for Payer: ASR Commercial |
$1,297.00
|
| Rate for Payer: BCBS Complete |
$534.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.96
|
| Rate for Payer: BCN Commercial |
$1,036.66
|
| Rate for Payer: Cash Price |
$1,069.68
|
| Rate for Payer: Cofinity Commercial |
$1,256.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,337.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,297.00
|
| Rate for Payer: Mclaren Commercial |
$1,203.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.54
|
| Rate for Payer: Nomi Health Commercial |
$1,096.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,171.58
|
| Rate for Payer: Priority Health Narrow Network |
$937.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,176.66
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
IP
|
$76.84
|
|
|
Service Code
|
NDC 16729002110
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$76.84 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: ASR ASR |
$74.53
|
| Rate for Payer: ASR Commercial |
$74.53
|
| Rate for Payer: BCBS Trust/PPO |
$62.62
|
| Rate for Payer: BCN Commercial |
$59.57
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Healthscope Commercial |
$76.84
|
| Rate for Payer: Healthscope Whirlpool |
$74.53
|
| Rate for Payer: Mclaren Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.62
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
IP
|
$75.17
|
|
|
Service Code
|
NDC 00781542131
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.86 |
| Max. Negotiated Rate |
$75.17 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: ASR ASR |
$72.91
|
| Rate for Payer: ASR Commercial |
$72.91
|
| Rate for Payer: BCBS Trust/PPO |
$61.26
|
| Rate for Payer: BCN Commercial |
$58.28
|
| Rate for Payer: Cash Price |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$70.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.14
|
| Rate for Payer: Healthscope Commercial |
$75.17
|
| Rate for Payer: Healthscope Whirlpool |
$72.91
|
| Rate for Payer: Mclaren Commercial |
$67.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.89
|
| Rate for Payer: Nomi Health Commercial |
$61.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.15
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
IP
|
$2,043.29
|
|
|
Service Code
|
NDC 64764030114
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,328.14 |
| Max. Negotiated Rate |
$2,043.29 |
| Rate for Payer: Aetna Commercial |
$1,838.96
|
| Rate for Payer: ASR ASR |
$1,981.99
|
| Rate for Payer: ASR Commercial |
$1,981.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,665.08
|
| Rate for Payer: BCN Commercial |
$1,584.16
|
| Rate for Payer: Cash Price |
$1,634.63
|
| Rate for Payer: Cofinity Commercial |
$1,920.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,634.63
|
| Rate for Payer: Healthscope Commercial |
$2,043.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.99
|
| Rate for Payer: Mclaren Commercial |
$1,838.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,736.80
|
| Rate for Payer: Nomi Health Commercial |
$1,675.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,798.10
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
OP
|
$135.36
|
|
|
Service Code
|
NDC 57237022030
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.14 |
| Max. Negotiated Rate |
$135.36 |
| Rate for Payer: Aetna Commercial |
$121.82
|
| Rate for Payer: Aetna Medicare |
$67.68
|
| Rate for Payer: ASR ASR |
$131.30
|
| Rate for Payer: ASR Commercial |
$131.30
|
| Rate for Payer: BCBS Complete |
$54.14
|
| Rate for Payer: BCBS Trust/PPO |
$110.85
|
| Rate for Payer: BCN Commercial |
$104.94
|
| Rate for Payer: Cash Price |
$108.29
|
| Rate for Payer: Cofinity Commercial |
$127.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.29
|
| Rate for Payer: Healthscope Commercial |
$135.36
|
| Rate for Payer: Healthscope Whirlpool |
$131.30
|
| Rate for Payer: Mclaren Commercial |
$121.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.06
|
| Rate for Payer: Nomi Health Commercial |
$111.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.60
|
| Rate for Payer: Priority Health Narrow Network |
$94.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.12
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
OP
|
$76.84
|
|
|
Service Code
|
NDC 16729002110
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$76.84 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Medicare |
$38.42
|
| Rate for Payer: ASR ASR |
$74.53
|
| Rate for Payer: ASR Commercial |
$74.53
|
| Rate for Payer: BCBS Complete |
$30.74
|
| Rate for Payer: BCBS Trust/PPO |
$62.92
|
| Rate for Payer: BCN Commercial |
$59.57
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Healthscope Commercial |
$76.84
|
| Rate for Payer: Healthscope Whirlpool |
$74.53
|
| Rate for Payer: Mclaren Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.33
|
| Rate for Payer: Priority Health Narrow Network |
$53.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.62
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
OP
|
$2,043.29
|
|
|
Service Code
|
NDC 64764030114
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$817.32 |
| Max. Negotiated Rate |
$2,043.29 |
| Rate for Payer: Aetna Commercial |
$1,838.96
|
| Rate for Payer: Aetna Medicare |
$1,021.64
|
| Rate for Payer: ASR ASR |
$1,981.99
|
| Rate for Payer: ASR Commercial |
$1,981.99
|
| Rate for Payer: BCBS Complete |
$817.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.25
|
| Rate for Payer: BCN Commercial |
$1,584.16
|
| Rate for Payer: Cash Price |
$1,634.63
|
| Rate for Payer: Cofinity Commercial |
$1,920.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,634.63
|
| Rate for Payer: Healthscope Commercial |
$2,043.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.99
|
| Rate for Payer: Mclaren Commercial |
$1,838.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,736.80
|
| Rate for Payer: Nomi Health Commercial |
$1,675.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,790.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,432.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,798.10
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
OP
|
$75.17
|
|
|
Service Code
|
NDC 00781542131
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.07 |
| Max. Negotiated Rate |
$75.17 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$37.59
|
| Rate for Payer: ASR ASR |
$72.91
|
| Rate for Payer: ASR Commercial |
$72.91
|
| Rate for Payer: BCBS Complete |
$30.07
|
| Rate for Payer: BCBS Trust/PPO |
$61.56
|
| Rate for Payer: BCN Commercial |
$58.28
|
| Rate for Payer: Cash Price |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$70.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.14
|
| Rate for Payer: Healthscope Commercial |
$75.17
|
| Rate for Payer: Healthscope Whirlpool |
$72.91
|
| Rate for Payer: Mclaren Commercial |
$67.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.89
|
| Rate for Payer: Nomi Health Commercial |
$61.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.86
|
| Rate for Payer: Priority Health Narrow Network |
$52.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.15
|
|
|
PIOGLITAZONE 30 MG TABLET
|
Facility
|
IP
|
$135.36
|
|
|
Service Code
|
NDC 57237022030
|
| Hospital Charge Code |
25529
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.98 |
| Max. Negotiated Rate |
$135.36 |
| Rate for Payer: Aetna Commercial |
$121.82
|
| Rate for Payer: ASR ASR |
$131.30
|
| Rate for Payer: ASR Commercial |
$131.30
|
| Rate for Payer: BCBS Trust/PPO |
$110.30
|
| Rate for Payer: BCN Commercial |
$104.94
|
| Rate for Payer: Cash Price |
$108.29
|
| Rate for Payer: Cofinity Commercial |
$127.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.29
|
| Rate for Payer: Healthscope Commercial |
$135.36
|
| Rate for Payer: Healthscope Whirlpool |
$131.30
|
| Rate for Payer: Mclaren Commercial |
$121.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.06
|
| Rate for Payer: Nomi Health Commercial |
$111.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.12
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$29.14
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.94 |
| Max. Negotiated Rate |
$29.14 |
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: ASR ASR |
$28.27
|
| Rate for Payer: ASR Commercial |
$28.27
|
| Rate for Payer: BCBS Trust/PPO |
$23.75
|
| Rate for Payer: BCN Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$23.31
|
| Rate for Payer: Cofinity Commercial |
$27.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.31
|
| Rate for Payer: Healthscope Commercial |
$29.14
|
| Rate for Payer: Healthscope Whirlpool |
$28.27
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.77
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.64
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$29.14
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$29.14 |
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: Aetna Medicare |
$14.57
|
| Rate for Payer: ASR ASR |
$28.27
|
| Rate for Payer: ASR Commercial |
$28.27
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$22.59
|
| Rate for Payer: Cash Price |
$23.31
|
| Rate for Payer: Cofinity Commercial |
$27.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.31
|
| Rate for Payer: Healthscope Commercial |
$29.14
|
| Rate for Payer: Healthscope Whirlpool |
$28.27
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.77
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.53
|
| Rate for Payer: Priority Health Narrow Network |
$20.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.64
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.85
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18304
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$20.57
|
| Rate for Payer: Aetna Commercial |
$19.19
|
| Rate for Payer: Aetna Commercial |
$17.12
|
| Rate for Payer: Aetna Commercial |
$15.52
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: Aetna Commercial |
$21.64
|
| Rate for Payer: Aetna Medicare |
$12.02
|
| Rate for Payer: Aetna Medicare |
$10.66
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Aetna Medicare |
$8.26
|
| Rate for Payer: Aetna Medicare |
$14.57
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Aetna Medicare |
$10.28
|
| Rate for Payer: Aetna Medicare |
$9.51
|
| Rate for Payer: ASR ASR |
$18.45
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: ASR ASR |
$19.94
|
| Rate for Payer: ASR ASR |
$16.72
|
| Rate for Payer: ASR ASR |
$22.16
|
| Rate for Payer: ASR ASR |
$28.27
|
| Rate for Payer: ASR ASR |
$20.68
|
| Rate for Payer: ASR ASR |
$23.32
|
| Rate for Payer: ASR Commercial |
$23.32
|
| Rate for Payer: ASR Commercial |
$18.45
|
| Rate for Payer: ASR Commercial |
$20.68
|
| Rate for Payer: ASR Commercial |
$16.72
|
| Rate for Payer: ASR Commercial |
$16.02
|
| Rate for Payer: ASR Commercial |
$19.94
|
| Rate for Payer: ASR Commercial |
$28.27
|
| Rate for Payer: ASR Commercial |
$22.16
|
| Rate for Payer: BCBS Complete |
$6.90
|
| Rate for Payer: BCBS Complete |
$6.61
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS Complete |
$8.53
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS Trust/PPO |
$16.84
|
| Rate for Payer: BCBS Trust/PPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$18.71
|
| Rate for Payer: BCBS Trust/PPO |
$19.69
|
| Rate for Payer: BCBS Trust/PPO |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$14.12
|
| Rate for Payer: BCBS Trust/PPO |
$17.46
|
| Rate for Payer: BCBS Trust/PPO |
$23.86
|
| Rate for Payer: BCN Commercial |
$16.53
|
| Rate for Payer: BCN Commercial |
$22.59
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Commercial |
$15.94
|
| Rate for Payer: BCN Commercial |
$13.37
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: BCN Commercial |
$14.75
|
| Rate for Payer: BCN Commercial |
$17.72
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$23.31
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cash Price |
$13.79
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Cofinity Commercial |
$21.48
|
| Rate for Payer: Cofinity Commercial |
$19.33
|
| Rate for Payer: Cofinity Commercial |
$27.39
|
| Rate for Payer: Cofinity Commercial |
$17.88
|
| Rate for Payer: Cofinity Commercial |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Cofinity Commercial |
$20.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Healthscope Commercial |
$21.32
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$24.04
|
| Rate for Payer: Healthscope Commercial |
$29.14
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: Healthscope Commercial |
$17.24
|
| Rate for Payer: Healthscope Whirlpool |
$22.16
|
| Rate for Payer: Healthscope Whirlpool |
$23.32
|
| Rate for Payer: Healthscope Whirlpool |
$20.68
|
| Rate for Payer: Healthscope Whirlpool |
$16.02
|
| Rate for Payer: Healthscope Whirlpool |
$19.94
|
| Rate for Payer: Healthscope Whirlpool |
$28.27
|
| Rate for Payer: Healthscope Whirlpool |
$18.45
|
| Rate for Payer: Healthscope Whirlpool |
$16.72
|
| Rate for Payer: Mclaren Commercial |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$21.64
|
| Rate for Payer: Mclaren Commercial |
$20.57
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Mclaren Commercial |
$19.19
|
| Rate for Payer: Mclaren Commercial |
$18.50
|
| Rate for Payer: Mclaren Commercial |
$14.87
|
| Rate for Payer: Mclaren Commercial |
$15.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.43
|
| Rate for Payer: Nomi Health Commercial |
$16.86
|
| Rate for Payer: Nomi Health Commercial |
$17.48
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Nomi Health Commercial |
$18.74
|
| Rate for Payer: Nomi Health Commercial |
$15.60
|
| Rate for Payer: Nomi Health Commercial |
$19.71
|
| Rate for Payer: Nomi Health Commercial |
$13.55
|
| Rate for Payer: Nomi Health Commercial |
$14.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.02
|
| Rate for Payer: Priority Health Narrow Network |
$16.02
|
| Rate for Payer: Priority Health Narrow Network |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$20.43
|
| Rate for Payer: Priority Health Narrow Network |
$14.95
|
| Rate for Payer: Priority Health Narrow Network |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$13.33
|
| Rate for Payer: Priority Health Narrow Network |
$11.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.09
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.02
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18304
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$19.02 |
| Rate for Payer: Aetna Commercial |
$17.12
|
| Rate for Payer: Aetna Commercial |
$19.19
|
| Rate for Payer: Aetna Commercial |
$20.57
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$26.23
|
| Rate for Payer: Aetna Commercial |
$21.64
|
| Rate for Payer: Aetna Commercial |
$15.52
|
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: ASR ASR |
$20.68
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: ASR ASR |
$23.32
|
| Rate for Payer: ASR ASR |
$28.27
|
| Rate for Payer: ASR ASR |
$19.94
|
| Rate for Payer: ASR ASR |
$22.16
|
| Rate for Payer: ASR ASR |
$18.45
|
| Rate for Payer: ASR ASR |
$16.72
|
| Rate for Payer: ASR Commercial |
$23.32
|
| Rate for Payer: ASR Commercial |
$28.27
|
| Rate for Payer: ASR Commercial |
$18.45
|
| Rate for Payer: ASR Commercial |
$20.68
|
| Rate for Payer: ASR Commercial |
$19.94
|
| Rate for Payer: ASR Commercial |
$16.72
|
| Rate for Payer: ASR Commercial |
$16.02
|
| Rate for Payer: ASR Commercial |
$22.16
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.37
|
| Rate for Payer: BCBS Trust/PPO |
$14.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$23.75
|
| Rate for Payer: BCN Commercial |
$14.75
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: BCN Commercial |
$22.59
|
| Rate for Payer: BCN Commercial |
$17.72
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Commercial |
$16.53
|
| Rate for Payer: BCN Commercial |
$15.94
|
| Rate for Payer: BCN Commercial |
$13.37
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cash Price |
$23.31
|
| Rate for Payer: Cash Price |
$19.24
|
| Rate for Payer: Cash Price |
$15.21
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cash Price |
$13.79
|
| Rate for Payer: Cofinity Commercial |
$19.33
|
| Rate for Payer: Cofinity Commercial |
$21.48
|
| Rate for Payer: Cofinity Commercial |
$17.88
|
| Rate for Payer: Cofinity Commercial |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$27.39
|
| Rate for Payer: Cofinity Commercial |
$20.04
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Healthscope Commercial |
$29.14
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$19.02
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Healthscope Commercial |
$17.24
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$24.04
|
| Rate for Payer: Healthscope Commercial |
$21.32
|
| Rate for Payer: Healthscope Whirlpool |
$20.68
|
| Rate for Payer: Healthscope Whirlpool |
$23.32
|
| Rate for Payer: Healthscope Whirlpool |
$28.27
|
| Rate for Payer: Healthscope Whirlpool |
$19.94
|
| Rate for Payer: Healthscope Whirlpool |
$16.72
|
| Rate for Payer: Healthscope Whirlpool |
$18.45
|
| Rate for Payer: Healthscope Whirlpool |
$16.02
|
| Rate for Payer: Healthscope Whirlpool |
$22.16
|
| Rate for Payer: Mclaren Commercial |
$15.52
|
| Rate for Payer: Mclaren Commercial |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$14.87
|
| Rate for Payer: Mclaren Commercial |
$18.50
|
| Rate for Payer: Mclaren Commercial |
$19.19
|
| Rate for Payer: Mclaren Commercial |
$20.57
|
| Rate for Payer: Mclaren Commercial |
$21.64
|
| Rate for Payer: Mclaren Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.48
|
| Rate for Payer: Nomi Health Commercial |
$18.74
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Nomi Health Commercial |
$17.48
|
| Rate for Payer: Nomi Health Commercial |
$13.55
|
| Rate for Payer: Nomi Health Commercial |
$16.86
|
| Rate for Payer: Nomi Health Commercial |
$15.60
|
| Rate for Payer: Nomi Health Commercial |
$14.14
|
| Rate for Payer: Nomi Health Commercial |
$19.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.11
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$35.38
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.15 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$31.84
|
| Rate for Payer: Aetna Medicare |
$17.69
|
| Rate for Payer: ASR ASR |
$34.32
|
| Rate for Payer: ASR Commercial |
$34.32
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$28.97
|
| Rate for Payer: BCN Commercial |
$27.43
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Healthscope Whirlpool |
$34.32
|
| Rate for Payer: Mclaren Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Nomi Health Commercial |
$29.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.00
|
| Rate for Payer: Priority Health Narrow Network |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$35.38
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$31.84
|
| Rate for Payer: ASR ASR |
$34.32
|
| Rate for Payer: ASR Commercial |
$34.32
|
| Rate for Payer: BCBS Trust/PPO |
$28.83
|
| Rate for Payer: BCN Commercial |
$27.43
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Healthscope Whirlpool |
$34.32
|
| Rate for Payer: Mclaren Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Nomi Health Commercial |
$29.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.37
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18303
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$22.37 |
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$19.14
|
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Commercial |
$24.94
|
| Rate for Payer: Aetna Commercial |
$15.82
|
| Rate for Payer: Aetna Commercial |
$23.18
|
| Rate for Payer: Aetna Commercial |
$24.57
|
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Medicare |
$11.35
|
| Rate for Payer: Aetna Medicare |
$12.88
|
| Rate for Payer: Aetna Medicare |
$10.63
|
| Rate for Payer: Aetna Medicare |
$11.73
|
| Rate for Payer: Aetna Medicare |
$8.79
|
| Rate for Payer: Aetna Medicare |
$13.86
|
| Rate for Payer: Aetna Medicare |
$13.65
|
| Rate for Payer: Aetna Medicare |
$10.81
|
| Rate for Payer: Aetna Medicare |
$11.19
|
| Rate for Payer: ASR ASR |
$26.48
|
| Rate for Payer: ASR ASR |
$26.88
|
| Rate for Payer: ASR ASR |
$20.97
|
| Rate for Payer: ASR ASR |
$17.05
|
| Rate for Payer: ASR ASR |
$21.70
|
| Rate for Payer: ASR ASR |
$20.63
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: ASR ASR |
$24.99
|
| Rate for Payer: ASR ASR |
$22.02
|
| Rate for Payer: ASR Commercial |
$26.88
|
| Rate for Payer: ASR Commercial |
$24.99
|
| Rate for Payer: ASR Commercial |
$22.02
|
| Rate for Payer: ASR Commercial |
$17.05
|
| Rate for Payer: ASR Commercial |
$21.70
|
| Rate for Payer: ASR Commercial |
$20.97
|
| Rate for Payer: ASR Commercial |
$20.63
|
| Rate for Payer: ASR Commercial |
$26.48
|
| Rate for Payer: ASR Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$9.38
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS Complete |
$8.65
|
| Rate for Payer: BCBS Complete |
$9.08
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Complete |
$7.03
|
| Rate for Payer: BCBS Trust/PPO |
$22.69
|
| Rate for Payer: BCBS Trust/PPO |
$19.21
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCBS Trust/PPO |
$14.40
|
| Rate for Payer: BCBS Trust/PPO |
$17.42
|
| Rate for Payer: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCBS Trust/PPO |
$22.36
|
| Rate for Payer: BCBS Trust/PPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$18.59
|
| Rate for Payer: BCN Commercial |
$18.19
|
| Rate for Payer: BCN Commercial |
$17.60
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Commercial |
$13.63
|
| Rate for Payer: BCN Commercial |
$16.76
|
| Rate for Payer: BCN Commercial |
$21.17
|
| Rate for Payer: BCN Commercial |
$19.97
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$21.84
|
| Rate for Payer: Cash Price |
$20.61
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cash Price |
$22.17
|
| Rate for Payer: Cash Price |
$17.02
|
| Rate for Payer: Cash Price |
$17.29
|
| Rate for Payer: Cash Price |
$14.06
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$24.21
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Cofinity Commercial |
$21.03
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$25.66
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Commercial |
$16.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$25.76
|
| Rate for Payer: Healthscope Commercial |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$21.62
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$27.71
|
| Rate for Payer: Healthscope Commercial |
$22.70
|
| Rate for Payer: Healthscope Whirlpool |
$22.76
|
| Rate for Payer: Healthscope Whirlpool |
$20.97
|
| Rate for Payer: Healthscope Whirlpool |
$20.63
|
| Rate for Payer: Healthscope Whirlpool |
$17.05
|
| Rate for Payer: Healthscope Whirlpool |
$21.70
|
| Rate for Payer: Healthscope Whirlpool |
$22.02
|
| Rate for Payer: Healthscope Whirlpool |
$24.99
|
| Rate for Payer: Healthscope Whirlpool |
$26.48
|
| Rate for Payer: Healthscope Whirlpool |
$26.88
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Mclaren Commercial |
$20.43
|
| Rate for Payer: Mclaren Commercial |
$15.82
|
| Rate for Payer: Mclaren Commercial |
$19.14
|
| Rate for Payer: Mclaren Commercial |
$19.46
|
| Rate for Payer: Mclaren Commercial |
$24.57
|
| Rate for Payer: Mclaren Commercial |
$20.13
|
| Rate for Payer: Mclaren Commercial |
$24.94
|
| Rate for Payer: Mclaren Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.01
|
| Rate for Payer: Nomi Health Commercial |
$14.42
|
| Rate for Payer: Nomi Health Commercial |
$22.39
|
| Rate for Payer: Nomi Health Commercial |
$22.72
|
| Rate for Payer: Nomi Health Commercial |
$19.24
|
| Rate for Payer: Nomi Health Commercial |
$18.61
|
| Rate for Payer: Nomi Health Commercial |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$21.12
|
| Rate for Payer: Nomi Health Commercial |
$17.44
|
| Rate for Payer: Nomi Health Commercial |
$17.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$16.45
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$14.91
|
| Rate for Payer: Priority Health Narrow Network |
$19.14
|
| Rate for Payer: Priority Health Narrow Network |
$15.91
|
| Rate for Payer: Priority Health Narrow Network |
$18.06
|
| Rate for Payer: Priority Health Narrow Network |
$15.68
|
| Rate for Payer: Priority Health Narrow Network |
$15.16
|
| Rate for Payer: Priority Health Narrow Network |
$19.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.02
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.58
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18303
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.43 |
| Max. Negotiated Rate |
$17.58 |
| Rate for Payer: Aetna Commercial |
$15.82
|
| Rate for Payer: Aetna Commercial |
$24.57
|
| Rate for Payer: Aetna Commercial |
$23.18
|
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Commercial |
$24.94
|
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$19.14
|
| Rate for Payer: ASR ASR |
$26.88
|
| Rate for Payer: ASR ASR |
$22.02
|
| Rate for Payer: ASR ASR |
$21.70
|
| Rate for Payer: ASR ASR |
$20.63
|
| Rate for Payer: ASR ASR |
$17.05
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: ASR ASR |
$20.97
|
| Rate for Payer: ASR ASR |
$24.99
|
| Rate for Payer: ASR ASR |
$26.48
|
| Rate for Payer: ASR Commercial |
$26.88
|
| Rate for Payer: ASR Commercial |
$22.76
|
| Rate for Payer: ASR Commercial |
$22.02
|
| Rate for Payer: ASR Commercial |
$26.48
|
| Rate for Payer: ASR Commercial |
$24.99
|
| Rate for Payer: ASR Commercial |
$17.05
|
| Rate for Payer: ASR Commercial |
$20.63
|
| Rate for Payer: ASR Commercial |
$21.70
|
| Rate for Payer: ASR Commercial |
$20.97
|
| Rate for Payer: BCBS Trust/PPO |
$18.23
|
| Rate for Payer: BCBS Trust/PPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$18.50
|
| Rate for Payer: BCBS Trust/PPO |
$14.33
|
| Rate for Payer: BCBS Trust/PPO |
$17.33
|
| Rate for Payer: BCBS Trust/PPO |
$17.62
|
| Rate for Payer: BCBS Trust/PPO |
$22.58
|
| Rate for Payer: BCBS Trust/PPO |
$22.25
|
| Rate for Payer: BCBS Trust/PPO |
$20.99
|
| Rate for Payer: BCN Commercial |
$13.63
|
| Rate for Payer: BCN Commercial |
$17.60
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: BCN Commercial |
$18.19
|
| Rate for Payer: BCN Commercial |
$21.17
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: BCN Commercial |
$16.76
|
| Rate for Payer: BCN Commercial |
$19.97
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cash Price |
$20.61
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cash Price |
$17.02
|
| Rate for Payer: Cash Price |
$21.84
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$14.06
|
| Rate for Payer: Cash Price |
$22.17
|
| Rate for Payer: Cash Price |
$17.29
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Cofinity Commercial |
$21.03
|
| Rate for Payer: Cofinity Commercial |
$25.66
|
| Rate for Payer: Cofinity Commercial |
$24.21
|
| Rate for Payer: Cofinity Commercial |
$16.53
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.30
|
| Rate for Payer: Healthscope Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$21.62
|
| Rate for Payer: Healthscope Commercial |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$22.70
|
| Rate for Payer: Healthscope Commercial |
$25.76
|
| Rate for Payer: Healthscope Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$27.71
|
| Rate for Payer: Healthscope Whirlpool |
$24.99
|
| Rate for Payer: Healthscope Whirlpool |
$26.88
|
| Rate for Payer: Healthscope Whirlpool |
$17.05
|
| Rate for Payer: Healthscope Whirlpool |
$22.02
|
| Rate for Payer: Healthscope Whirlpool |
$21.70
|
| Rate for Payer: Healthscope Whirlpool |
$20.63
|
| Rate for Payer: Healthscope Whirlpool |
$26.48
|
| Rate for Payer: Healthscope Whirlpool |
$22.76
|
| Rate for Payer: Healthscope Whirlpool |
$20.97
|
| Rate for Payer: Mclaren Commercial |
$20.43
|
| Rate for Payer: Mclaren Commercial |
$24.57
|
| Rate for Payer: Mclaren Commercial |
$24.94
|
| Rate for Payer: Mclaren Commercial |
$19.14
|
| Rate for Payer: Mclaren Commercial |
$19.46
|
| Rate for Payer: Mclaren Commercial |
$23.18
|
| Rate for Payer: Mclaren Commercial |
$15.82
|
| Rate for Payer: Mclaren Commercial |
$20.13
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.38
|
| Rate for Payer: Nomi Health Commercial |
$18.61
|
| Rate for Payer: Nomi Health Commercial |
$19.24
|
| Rate for Payer: Nomi Health Commercial |
$22.72
|
| Rate for Payer: Nomi Health Commercial |
$21.12
|
| Rate for Payer: Nomi Health Commercial |
$14.42
|
| Rate for Payer: Nomi Health Commercial |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$17.73
|
| Rate for Payer: Nomi Health Commercial |
$17.44
|
| Rate for Payer: Nomi Health Commercial |
$22.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.98
|
|
|
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$28.41 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Commercial |
$23.48
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Commercial |
$15.88
|
| Rate for Payer: Aetna Commercial |
$23.84
|
| Rate for Payer: Aetna Medicare |
$14.21
|
| Rate for Payer: Aetna Medicare |
$9.52
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Aetna Medicare |
$8.82
|
| Rate for Payer: Aetna Medicare |
$13.04
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: ASR ASR |
$19.59
|
| Rate for Payer: ASR ASR |
$25.70
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR ASR |
$25.31
|
| Rate for Payer: ASR ASR |
$18.47
|
| Rate for Payer: ASR ASR |
$23.26
|
| Rate for Payer: ASR ASR |
$17.12
|
| Rate for Payer: ASR Commercial |
$19.59
|
| Rate for Payer: ASR Commercial |
$17.12
|
| Rate for Payer: ASR Commercial |
$25.31
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: ASR Commercial |
$25.70
|
| Rate for Payer: ASR Commercial |
$18.47
|
| Rate for Payer: ASR Commercial |
$23.26
|
| Rate for Payer: BCBS Complete |
$9.59
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS Complete |
$10.44
|
| Rate for Payer: BCBS Complete |
$8.08
|
| Rate for Payer: BCBS Complete |
$7.62
|
| Rate for Payer: BCBS Complete |
$11.36
|
| Rate for Payer: BCBS Complete |
$10.60
|
| Rate for Payer: BCBS Trust/PPO |
$21.69
|
| Rate for Payer: BCBS Trust/PPO |
$19.64
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCBS Trust/PPO |
$15.59
|
| Rate for Payer: BCBS Trust/PPO |
$16.54
|
| Rate for Payer: BCBS Trust/PPO |
$21.37
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$20.54
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: BCN Commercial |
$18.59
|
| Rate for Payer: BCN Commercial |
$14.76
|
| Rate for Payer: BCN Commercial |
$13.68
|
| Rate for Payer: BCN Commercial |
$15.66
|
| Rate for Payer: Cash Price |
$14.12
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cash Price |
$21.19
|
| Rate for Payer: Cash Price |
$20.87
|
| Rate for Payer: Cash Price |
$15.23
|
| Rate for Payer: Cash Price |
$16.16
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Cofinity Commercial |
$24.90
|
| Rate for Payer: Cofinity Commercial |
$16.59
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$22.54
|
| Rate for Payer: Cofinity Commercial |
$18.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.87
|
| Rate for Payer: Healthscope Commercial |
$17.65
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$23.98
|
| Rate for Payer: Healthscope Commercial |
$19.04
|
| Rate for Payer: Healthscope Commercial |
$26.09
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Healthscope Whirlpool |
$19.59
|
| Rate for Payer: Healthscope Whirlpool |
$17.12
|
| Rate for Payer: Healthscope Whirlpool |
$23.26
|
| Rate for Payer: Healthscope Whirlpool |
$25.31
|
| Rate for Payer: Healthscope Whirlpool |
$25.70
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Healthscope Whirlpool |
$18.47
|
| Rate for Payer: Mclaren Commercial |
$18.18
|
| Rate for Payer: Mclaren Commercial |
$23.48
|
| Rate for Payer: Mclaren Commercial |
$23.84
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Mclaren Commercial |
$21.58
|
| Rate for Payer: Mclaren Commercial |
$15.88
|
| Rate for Payer: Mclaren Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$16.56
|
| Rate for Payer: Nomi Health Commercial |
$21.72
|
| Rate for Payer: Nomi Health Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Nomi Health Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$14.47
|
| Rate for Payer: Nomi Health Commercial |
$19.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.68
|
| Rate for Payer: Priority Health Narrow Network |
$13.35
|
| Rate for Payer: Priority Health Narrow Network |
$16.81
|
| Rate for Payer: Priority Health Narrow Network |
$14.16
|
| Rate for Payer: Priority Health Narrow Network |
$12.37
|
| Rate for Payer: Priority Health Narrow Network |
$18.57
|
| Rate for Payer: Priority Health Narrow Network |
$18.29
|
| Rate for Payer: Priority Health Narrow Network |
$19.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.53
|
|
