|
POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID
|
Facility
|
OP
|
$20.54
|
|
|
Service Code
|
NDC 66689004701
|
| Hospital Charge Code |
6432
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$20.54 |
| Rate for Payer: Aetna Commercial |
$18.48
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: ASR ASR |
$19.92
|
| Rate for Payer: BCBS Complete |
$8.21
|
| Rate for Payer: BCBS Trust/PPO |
$16.93
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: Cash Price |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.43
|
| Rate for Payer: Healthscope Commercial |
$19.92
|
| Rate for Payer: Healthscope Whirlpool |
$20.54
|
| Rate for Payer: Mclaren Commercial |
$18.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.45
|
| Rate for Payer: Nomi Health Commercial |
$16.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17.99
|
| Rate for Payer: Priority Health Narrow Network |
$14.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.07
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
11081
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$25.87
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Commercial |
$57.65
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.13
|
| Rate for Payer: Priority Health Narrow Network |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
11081
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 338080304
|
| Hospital Charge Code |
9795
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.89 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$39.29
|
| Rate for Payer: BCN Commercial |
$39.29
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$95.70
|
|
|
Service Code
|
NDC 264765200
|
| Hospital Charge Code |
9795
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.41 |
| Max. Negotiated Rate |
$95.70 |
| Rate for Payer: Aetna Commercial |
$86.13
|
| Rate for Payer: Aetna Medicare |
$35.41
|
| Rate for Payer: ASR ASR |
$92.83
|
| Rate for Payer: BCBS Complete |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.90
|
| Rate for Payer: BCN Commercial |
$78.90
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$89.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$92.83
|
| Rate for Payer: Healthscope Whirlpool |
$95.70
|
| Rate for Payer: Mclaren Commercial |
$86.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Nomi Health Commercial |
$78.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.85
|
| Rate for Payer: Priority Health Narrow Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.22
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 264765200
|
| Hospital Charge Code |
9795
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$71.78 |
| Max. Negotiated Rate |
$95.70 |
| Rate for Payer: Aetna Commercial |
$86.13
|
| Rate for Payer: ASR ASR |
$92.83
|
| Rate for Payer: BCBS Trust/PPO |
$78.59
|
| Rate for Payer: BCN Commercial |
$78.59
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$89.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$92.83
|
| Rate for Payer: Healthscope Whirlpool |
$95.70
|
| Rate for Payer: Mclaren Commercial |
$86.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Nomi Health Commercial |
$78.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.22
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 338080304
|
| Hospital Charge Code |
9795
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: Aetna Medicare |
$17.70
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Trust/PPO |
$39.45
|
| Rate for Payer: BCN Commercial |
$39.45
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.93
|
| Rate for Payer: Priority Health Narrow Network |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5W-0.45% NACL 1.5X MAINTENANCE
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
NDC 338067104
|
| Hospital Charge Code |
300206
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$25.87
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Commercial |
$57.65
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.26
|
| Rate for Payer: Priority Health Narrow Network |
$49.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5W-0.45% NACL 1.5X MAINTENANCE
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
NDC 338067104
|
| Hospital Charge Code |
300206
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5W-0.9% NACL 1.5X MAINTENANCE
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 338080304
|
| Hospital Charge Code |
300207
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: Aetna Medicare |
$17.70
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Trust/PPO |
$39.45
|
| Rate for Payer: BCN Commercial |
$39.45
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.93
|
| Rate for Payer: Priority Health Narrow Network |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN D5W-0.9% NACL 1.5X MAINTENANCE
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 338080304
|
| Hospital Charge Code |
300207
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.89 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$39.29
|
| Rate for Payer: BCN Commercial |
$39.29
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
NDC 338067104
|
| Hospital Charge Code |
9801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
NDC 338067104
|
| Hospital Charge Code |
9801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$25.87
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCN Commercial |
$57.65
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.26
|
| Rate for Payer: Priority Health Narrow Network |
$49.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.69
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
6429
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$15.69 |
| Rate for Payer: Aetna Commercial |
$14.12
|
| Rate for Payer: Aetna Commercial |
$18.82
|
| Rate for Payer: Aetna Commercial |
$16.70
|
| Rate for Payer: ASR ASR |
$20.29
|
| Rate for Payer: ASR ASR |
$15.22
|
| Rate for Payer: ASR ASR |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.18
|
| Rate for Payer: BCBS Trust/PPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Commercial |
$12.88
|
| Rate for Payer: BCN Commercial |
$17.18
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$14.85
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Cofinity Commercial |
$17.45
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.85
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Healthscope Commercial |
$15.22
|
| Rate for Payer: Healthscope Commercial |
$20.29
|
| Rate for Payer: Healthscope Whirlpool |
$18.56
|
| Rate for Payer: Healthscope Whirlpool |
$20.91
|
| Rate for Payer: Healthscope Whirlpool |
$15.69
|
| Rate for Payer: Mclaren Commercial |
$16.70
|
| Rate for Payer: Mclaren Commercial |
$14.12
|
| Rate for Payer: Mclaren Commercial |
$18.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.33
|
| Rate for Payer: Nomi Health Commercial |
$15.22
|
| Rate for Payer: Nomi Health Commercial |
$12.86
|
| Rate for Payer: Nomi Health Commercial |
$17.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.81
|
|
|
POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.69
|
|
|
Service Code
|
HCPCS J3480
|
| Hospital Charge Code |
6429
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$15.69 |
| Rate for Payer: Aetna Commercial |
$14.12
|
| Rate for Payer: Aetna Commercial |
$16.70
|
| Rate for Payer: Aetna Commercial |
$18.82
|
| Rate for Payer: Aetna Medicare |
$6.87
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Aetna Medicare |
$7.74
|
| Rate for Payer: ASR ASR |
$20.29
|
| Rate for Payer: ASR ASR |
$15.22
|
| Rate for Payer: ASR ASR |
$18.00
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS Complete |
$8.37
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.93
|
| Rate for Payer: BCBS Trust/PPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.24
|
| Rate for Payer: BCN Commercial |
$12.93
|
| Rate for Payer: BCN Commercial |
$15.30
|
| Rate for Payer: BCN Commercial |
$17.24
|
| Rate for Payer: Cash Price |
$14.85
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$14.85
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cofinity Commercial |
$17.45
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.85
|
| Rate for Payer: Healthscope Commercial |
$20.29
|
| Rate for Payer: Healthscope Commercial |
$15.22
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Healthscope Whirlpool |
$18.56
|
| Rate for Payer: Healthscope Whirlpool |
$15.69
|
| Rate for Payer: Healthscope Whirlpool |
$20.91
|
| Rate for Payer: Mclaren Commercial |
$18.82
|
| Rate for Payer: Mclaren Commercial |
$16.70
|
| Rate for Payer: Mclaren Commercial |
$14.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.33
|
| Rate for Payer: Nomi Health Commercial |
$17.15
|
| Rate for Payer: Nomi Health Commercial |
$12.86
|
| Rate for Payer: Nomi Health Commercial |
$15.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.13
|
| Rate for Payer: Priority Health Narrow Network |
$0.10
|
| Rate for Payer: Priority Health Narrow Network |
$0.10
|
| Rate for Payer: Priority Health Narrow Network |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.81
|
|
|
POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$111.65
|
|
|
Service Code
|
NDC 990711609
|
| Hospital Charge Code |
11082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$41.31 |
| Max. Negotiated Rate |
$111.65 |
| Rate for Payer: Aetna Commercial |
$100.48
|
| Rate for Payer: Aetna Medicare |
$41.31
|
| Rate for Payer: ASR ASR |
$108.30
|
| Rate for Payer: BCBS Complete |
$44.66
|
| Rate for Payer: BCBS Trust/PPO |
$92.06
|
| Rate for Payer: BCN Commercial |
$92.06
|
| Rate for Payer: Cash Price |
$89.32
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.32
|
| Rate for Payer: Healthscope Commercial |
$108.30
|
| Rate for Payer: Healthscope Whirlpool |
$111.65
|
| Rate for Payer: Mclaren Commercial |
$100.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.90
|
| Rate for Payer: Nomi Health Commercial |
$91.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.83
|
| Rate for Payer: Priority Health Narrow Network |
$78.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.25
|
|
|
POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$111.65
|
|
|
Service Code
|
NDC 990711609
|
| Hospital Charge Code |
11082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$83.74 |
| Max. Negotiated Rate |
$111.65 |
| Rate for Payer: Aetna Commercial |
$100.48
|
| Rate for Payer: ASR ASR |
$108.30
|
| Rate for Payer: BCBS Trust/PPO |
$91.69
|
| Rate for Payer: BCN Commercial |
$91.69
|
| Rate for Payer: Cash Price |
$89.32
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.32
|
| Rate for Payer: Healthscope Commercial |
$108.30
|
| Rate for Payer: Healthscope Whirlpool |
$111.65
|
| Rate for Payer: Mclaren Commercial |
$100.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.90
|
| Rate for Payer: Nomi Health Commercial |
$91.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.25
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$260.85
|
|
|
Service Code
|
NDC 832532311
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.64 |
| Max. Negotiated Rate |
$260.85 |
| Rate for Payer: Aetna Commercial |
$234.76
|
| Rate for Payer: ASR ASR |
$253.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.21
|
| Rate for Payer: BCN Commercial |
$214.21
|
| Rate for Payer: Cash Price |
$208.68
|
| Rate for Payer: Cofinity Commercial |
$245.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.68
|
| Rate for Payer: Healthscope Commercial |
$253.02
|
| Rate for Payer: Healthscope Whirlpool |
$260.85
|
| Rate for Payer: Mclaren Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.72
|
| Rate for Payer: Nomi Health Commercial |
$213.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.55
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$286.90
|
|
|
Service Code
|
NDC 574027511
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.15 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Aetna Commercial |
$258.21
|
| Rate for Payer: Aetna Medicare |
$106.15
|
| Rate for Payer: ASR ASR |
$278.29
|
| Rate for Payer: BCBS Complete |
$114.76
|
| Rate for Payer: BCBS Trust/PPO |
$236.55
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Commercial |
$269.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Healthscope Commercial |
$278.29
|
| Rate for Payer: Healthscope Whirlpool |
$286.90
|
| Rate for Payer: Mclaren Commercial |
$258.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Nomi Health Commercial |
$235.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$251.38
|
| Rate for Payer: Priority Health Narrow Network |
$201.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.47
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.43
|
|
|
Service Code
|
NDC 60687069711
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$2.43 |
| Rate for Payer: Aetna Commercial |
$2.19
|
| Rate for Payer: Aetna Medicare |
$0.90
|
| Rate for Payer: ASR ASR |
$2.36
|
| Rate for Payer: BCBS Complete |
$0.97
|
| Rate for Payer: BCBS Trust/PPO |
$2.01
|
| Rate for Payer: BCN Commercial |
$2.01
|
| Rate for Payer: Cash Price |
$1.95
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.95
|
| Rate for Payer: Healthscope Commercial |
$2.36
|
| Rate for Payer: Healthscope Whirlpool |
$2.43
|
| Rate for Payer: Mclaren Commercial |
$2.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.07
|
| Rate for Payer: Nomi Health Commercial |
$1.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.14
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$243.20
|
|
|
Service Code
|
NDC 60687069701
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.98 |
| Max. Negotiated Rate |
$243.20 |
| Rate for Payer: Aetna Commercial |
$218.88
|
| Rate for Payer: Aetna Medicare |
$89.98
|
| Rate for Payer: ASR ASR |
$235.90
|
| Rate for Payer: BCBS Complete |
$97.28
|
| Rate for Payer: BCBS Trust/PPO |
$200.52
|
| Rate for Payer: BCN Commercial |
$200.52
|
| Rate for Payer: Cash Price |
$194.56
|
| Rate for Payer: Cofinity Commercial |
$228.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.56
|
| Rate for Payer: Healthscope Commercial |
$235.90
|
| Rate for Payer: Healthscope Whirlpool |
$243.20
|
| Rate for Payer: Mclaren Commercial |
$218.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.72
|
| Rate for Payer: Nomi Health Commercial |
$199.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$213.09
|
| Rate for Payer: Priority Health Narrow Network |
$170.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.02
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$181.64
|
|
|
Service Code
|
NDC 60687081009
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$181.64 |
| Rate for Payer: Aetna Commercial |
$163.48
|
| Rate for Payer: ASR ASR |
$176.19
|
| Rate for Payer: BCBS Trust/PPO |
$149.16
|
| Rate for Payer: BCN Commercial |
$149.16
|
| Rate for Payer: Cash Price |
$145.31
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.31
|
| Rate for Payer: Healthscope Commercial |
$176.19
|
| Rate for Payer: Healthscope Whirlpool |
$181.64
|
| Rate for Payer: Mclaren Commercial |
$163.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.39
|
| Rate for Payer: Nomi Health Commercial |
$148.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.84
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$181.64
|
|
|
Service Code
|
NDC 60687081009
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.21 |
| Max. Negotiated Rate |
$181.64 |
| Rate for Payer: Aetna Commercial |
$163.48
|
| Rate for Payer: Aetna Medicare |
$67.21
|
| Rate for Payer: ASR ASR |
$176.19
|
| Rate for Payer: BCBS Complete |
$72.66
|
| Rate for Payer: BCBS Trust/PPO |
$149.76
|
| Rate for Payer: BCN Commercial |
$149.76
|
| Rate for Payer: Cash Price |
$145.31
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.31
|
| Rate for Payer: Healthscope Commercial |
$176.19
|
| Rate for Payer: Healthscope Whirlpool |
$181.64
|
| Rate for Payer: Mclaren Commercial |
$163.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.39
|
| Rate for Payer: Nomi Health Commercial |
$148.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.15
|
| Rate for Payer: Priority Health Narrow Network |
$127.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.84
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$2.27
|
|
|
Service Code
|
NDC 60687081011
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$2.27 |
| Rate for Payer: Aetna Commercial |
$2.04
|
| Rate for Payer: Aetna Medicare |
$0.84
|
| Rate for Payer: ASR ASR |
$2.20
|
| Rate for Payer: BCBS Complete |
$0.91
|
| Rate for Payer: BCBS Trust/PPO |
$1.87
|
| Rate for Payer: BCN Commercial |
$1.87
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$2.20
|
| Rate for Payer: Healthscope Whirlpool |
$2.27
|
| Rate for Payer: Mclaren Commercial |
$2.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.93
|
| Rate for Payer: Nomi Health Commercial |
$1.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.99
|
| Rate for Payer: Priority Health Narrow Network |
$1.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.00
|
|
|
POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$2.87
|
|
|
Service Code
|
NDC 574027500
|
| Hospital Charge Code |
6436
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$2.87 |
| Rate for Payer: Aetna Commercial |
$2.58
|
| Rate for Payer: ASR ASR |
$2.78
|
| Rate for Payer: BCBS Trust/PPO |
$2.36
|
| Rate for Payer: BCN Commercial |
$2.36
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Healthscope Commercial |
$2.78
|
| Rate for Payer: Healthscope Whirlpool |
$2.87
|
| Rate for Payer: Mclaren Commercial |
$2.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Nomi Health Commercial |
$2.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.52
|
|
