|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$151.20
|
|
|
Service Code
|
NDC 00536100715
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.28 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: ASR ASR |
$146.66
|
| Rate for Payer: ASR Commercial |
$146.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.21
|
| Rate for Payer: BCN Commercial |
$117.23
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$142.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$146.66
|
| Rate for Payer: Mclaren Commercial |
$136.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.52
|
| Rate for Payer: Nomi Health Commercial |
$123.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.06
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$577.50
|
|
|
Service Code
|
NDC 66553000401
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$231.00 |
| Max. Negotiated Rate |
$577.50 |
| Rate for Payer: Aetna Commercial |
$519.75
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: ASR ASR |
$560.18
|
| Rate for Payer: ASR Commercial |
$560.18
|
| Rate for Payer: BCBS Complete |
$231.00
|
| Rate for Payer: BCBS Trust/PPO |
$472.91
|
| Rate for Payer: BCN Commercial |
$447.74
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cofinity Commercial |
$542.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$462.00
|
| Rate for Payer: Healthscope Commercial |
$577.50
|
| Rate for Payer: Healthscope Whirlpool |
$560.18
|
| Rate for Payer: Mclaren Commercial |
$519.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.88
|
| Rate for Payer: Nomi Health Commercial |
$473.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.01
|
| Rate for Payer: Priority Health Narrow Network |
$404.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$508.20
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$44.10
|
|
|
Service Code
|
NDC 50268014913
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.66 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$39.69
|
| Rate for Payer: ASR ASR |
$42.78
|
| Rate for Payer: ASR Commercial |
$42.78
|
| Rate for Payer: BCBS Trust/PPO |
$35.94
|
| Rate for Payer: BCN Commercial |
$34.19
|
| Rate for Payer: Cash Price |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$41.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.28
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Healthscope Whirlpool |
$42.78
|
| Rate for Payer: Mclaren Commercial |
$39.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.48
|
| Rate for Payer: Nomi Health Commercial |
$36.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.81
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$1.47
|
|
|
Service Code
|
NDC 50268014911
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Aetna Commercial |
$1.32
|
| Rate for Payer: ASR ASR |
$1.43
|
| Rate for Payer: ASR Commercial |
$1.43
|
| Rate for Payer: BCBS Trust/PPO |
$1.20
|
| Rate for Payer: BCN Commercial |
$1.14
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Healthscope Commercial |
$1.47
|
| Rate for Payer: Healthscope Whirlpool |
$1.43
|
| Rate for Payer: Mclaren Commercial |
$1.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.25
|
| Rate for Payer: Nomi Health Commercial |
$1.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.29
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
NDC 79854010892
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.20 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: Aetna Commercial |
$295.20
|
| Rate for Payer: Aetna Medicare |
$164.00
|
| Rate for Payer: ASR ASR |
$318.16
|
| Rate for Payer: ASR Commercial |
$318.16
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS Trust/PPO |
$268.60
|
| Rate for Payer: BCN Commercial |
$254.30
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$308.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Healthscope Commercial |
$328.00
|
| Rate for Payer: Healthscope Whirlpool |
$318.16
|
| Rate for Payer: Mclaren Commercial |
$295.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.80
|
| Rate for Payer: Nomi Health Commercial |
$268.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.39
|
| Rate for Payer: Priority Health Narrow Network |
$229.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.64
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$44.10
|
|
|
Service Code
|
NDC 50268014913
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.64 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$39.69
|
| Rate for Payer: Aetna Medicare |
$22.05
|
| Rate for Payer: ASR ASR |
$42.78
|
| Rate for Payer: ASR Commercial |
$42.78
|
| Rate for Payer: BCBS Complete |
$17.64
|
| Rate for Payer: BCBS Trust/PPO |
$36.11
|
| Rate for Payer: BCN Commercial |
$34.19
|
| Rate for Payer: Cash Price |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$41.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.28
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Healthscope Whirlpool |
$42.78
|
| Rate for Payer: Mclaren Commercial |
$39.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.48
|
| Rate for Payer: Nomi Health Commercial |
$36.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.64
|
| Rate for Payer: Priority Health Narrow Network |
$30.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.81
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
OP
|
$1.47
|
|
|
Service Code
|
NDC 50268014911
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$1.47 |
| Rate for Payer: Aetna Commercial |
$1.32
|
| Rate for Payer: Aetna Medicare |
$0.74
|
| Rate for Payer: ASR ASR |
$1.43
|
| Rate for Payer: ASR Commercial |
$1.43
|
| Rate for Payer: BCBS Complete |
$0.59
|
| Rate for Payer: BCBS Trust/PPO |
$1.20
|
| Rate for Payer: BCN Commercial |
$1.14
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Healthscope Commercial |
$1.47
|
| Rate for Payer: Healthscope Whirlpool |
$1.43
|
| Rate for Payer: Mclaren Commercial |
$1.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.25
|
| Rate for Payer: Nomi Health Commercial |
$1.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.29
|
| Rate for Payer: Priority Health Narrow Network |
$1.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.29
|
|
|
CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$328.00
|
|
|
Service Code
|
NDC 79854010892
|
| Hospital Charge Code |
1298
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$328.00 |
| Rate for Payer: Aetna Commercial |
$295.20
|
| Rate for Payer: ASR ASR |
$318.16
|
| Rate for Payer: ASR Commercial |
$318.16
|
| Rate for Payer: BCBS Trust/PPO |
$267.29
|
| Rate for Payer: BCN Commercial |
$254.30
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$308.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Healthscope Commercial |
$328.00
|
| Rate for Payer: Healthscope Whirlpool |
$318.16
|
| Rate for Payer: Mclaren Commercial |
$295.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.80
|
| Rate for Payer: Nomi Health Commercial |
$268.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.64
|
|
|
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
NDC 10006070038
|
| Hospital Charge Code |
19483
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.80 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: Aetna Commercial |
$154.80
|
| Rate for Payer: ASR ASR |
$166.84
|
| Rate for Payer: ASR Commercial |
$166.84
|
| Rate for Payer: BCBS Trust/PPO |
$140.16
|
| Rate for Payer: BCN Commercial |
$133.35
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Healthscope Commercial |
$172.00
|
| Rate for Payer: Healthscope Whirlpool |
$166.84
|
| Rate for Payer: Mclaren Commercial |
$154.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.20
|
| Rate for Payer: Nomi Health Commercial |
$141.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.36
|
|
|
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
NDC 10006070038
|
| Hospital Charge Code |
19483
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$172.00 |
| Rate for Payer: Aetna Commercial |
$154.80
|
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: ASR ASR |
$166.84
|
| Rate for Payer: ASR Commercial |
$166.84
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: BCBS Trust/PPO |
$140.85
|
| Rate for Payer: BCN Commercial |
$133.35
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Healthscope Commercial |
$172.00
|
| Rate for Payer: Healthscope Whirlpool |
$166.84
|
| Rate for Payer: Mclaren Commercial |
$154.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.20
|
| Rate for Payer: Nomi Health Commercial |
$141.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.71
|
| Rate for Payer: Priority Health Narrow Network |
$120.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.36
|
|
|
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET
|
Facility
|
IP
|
$106.70
|
|
|
Service Code
|
NDC 37864008289
|
| Hospital Charge Code |
19483
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.36 |
| Max. Negotiated Rate |
$106.70 |
| Rate for Payer: Aetna Commercial |
$96.03
|
| Rate for Payer: ASR ASR |
$103.50
|
| Rate for Payer: ASR Commercial |
$103.50
|
| Rate for Payer: BCBS Trust/PPO |
$86.95
|
| Rate for Payer: BCN Commercial |
$82.72
|
| Rate for Payer: Cash Price |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$100.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.36
|
| Rate for Payer: Healthscope Commercial |
$106.70
|
| Rate for Payer: Healthscope Whirlpool |
$103.50
|
| Rate for Payer: Mclaren Commercial |
$96.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.70
|
| Rate for Payer: Nomi Health Commercial |
$87.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.90
|
|
|
CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET
|
Facility
|
OP
|
$106.70
|
|
|
Service Code
|
NDC 37864008289
|
| Hospital Charge Code |
19483
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.68 |
| Max. Negotiated Rate |
$106.70 |
| Rate for Payer: Aetna Commercial |
$96.03
|
| Rate for Payer: Aetna Medicare |
$53.35
|
| Rate for Payer: ASR ASR |
$103.50
|
| Rate for Payer: ASR Commercial |
$103.50
|
| Rate for Payer: BCBS Complete |
$42.68
|
| Rate for Payer: BCBS Trust/PPO |
$87.38
|
| Rate for Payer: BCN Commercial |
$82.72
|
| Rate for Payer: Cash Price |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$100.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.36
|
| Rate for Payer: Healthscope Commercial |
$106.70
|
| Rate for Payer: Healthscope Whirlpool |
$103.50
|
| Rate for Payer: Mclaren Commercial |
$96.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.70
|
| Rate for Payer: Nomi Health Commercial |
$87.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.49
|
| Rate for Payer: Priority Health Narrow Network |
$74.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.90
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$5.04
|
|
|
Service Code
|
NDC 68084047911
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$5.04 |
| Rate for Payer: Aetna Commercial |
$4.54
|
| Rate for Payer: ASR ASR |
$4.89
|
| Rate for Payer: ASR Commercial |
$4.89
|
| Rate for Payer: BCBS Trust/PPO |
$4.11
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cofinity Commercial |
$4.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.03
|
| Rate for Payer: Healthscope Commercial |
$5.04
|
| Rate for Payer: Healthscope Whirlpool |
$4.89
|
| Rate for Payer: Mclaren Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.28
|
| Rate for Payer: Nomi Health Commercial |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.44
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
OP
|
$507.84
|
|
|
Service Code
|
NDC 00054008826
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$203.14 |
| Max. Negotiated Rate |
$507.84 |
| Rate for Payer: Aetna Commercial |
$457.06
|
| Rate for Payer: Aetna Medicare |
$253.92
|
| Rate for Payer: ASR ASR |
$492.60
|
| Rate for Payer: ASR Commercial |
$492.60
|
| Rate for Payer: BCBS Complete |
$203.14
|
| Rate for Payer: BCBS Trust/PPO |
$415.87
|
| Rate for Payer: BCN Commercial |
$393.73
|
| Rate for Payer: Cash Price |
$406.27
|
| Rate for Payer: Cofinity Commercial |
$477.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.27
|
| Rate for Payer: Healthscope Commercial |
$507.84
|
| Rate for Payer: Healthscope Whirlpool |
$492.60
|
| Rate for Payer: Mclaren Commercial |
$457.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Nomi Health Commercial |
$416.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.97
|
| Rate for Payer: Priority Health Narrow Network |
$356.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.90
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$565.44
|
|
|
Service Code
|
NDC 00781208102
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$367.54 |
| Max. Negotiated Rate |
$565.44 |
| Rate for Payer: Aetna Commercial |
$508.90
|
| Rate for Payer: ASR ASR |
$548.48
|
| Rate for Payer: ASR Commercial |
$548.48
|
| Rate for Payer: BCBS Trust/PPO |
$460.78
|
| Rate for Payer: BCN Commercial |
$438.39
|
| Rate for Payer: Cash Price |
$452.35
|
| Rate for Payer: Cofinity Commercial |
$531.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.35
|
| Rate for Payer: Healthscope Commercial |
$565.44
|
| Rate for Payer: Healthscope Whirlpool |
$548.48
|
| Rate for Payer: Mclaren Commercial |
$508.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.62
|
| Rate for Payer: Nomi Health Commercial |
$463.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.59
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
OP
|
$119.70
|
|
|
Service Code
|
NDC 00054008813
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.88 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Aetna Commercial |
$107.73
|
| Rate for Payer: Aetna Medicare |
$59.85
|
| Rate for Payer: ASR ASR |
$116.11
|
| Rate for Payer: ASR Commercial |
$116.11
|
| Rate for Payer: BCBS Complete |
$47.88
|
| Rate for Payer: BCBS Trust/PPO |
$98.02
|
| Rate for Payer: BCN Commercial |
$92.80
|
| Rate for Payer: Cash Price |
$95.76
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$119.70
|
| Rate for Payer: Healthscope Whirlpool |
$116.11
|
| Rate for Payer: Mclaren Commercial |
$107.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.74
|
| Rate for Payer: Nomi Health Commercial |
$98.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.88
|
| Rate for Payer: Priority Health Narrow Network |
$83.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.34
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
OP
|
$5.04
|
|
|
Service Code
|
NDC 68084047911
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$5.04 |
| Rate for Payer: Aetna Commercial |
$4.54
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: ASR ASR |
$4.89
|
| Rate for Payer: ASR Commercial |
$4.89
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Trust/PPO |
$4.13
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cofinity Commercial |
$4.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.03
|
| Rate for Payer: Healthscope Commercial |
$5.04
|
| Rate for Payer: Healthscope Whirlpool |
$4.89
|
| Rate for Payer: Mclaren Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.28
|
| Rate for Payer: Nomi Health Commercial |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.42
|
| Rate for Payer: Priority Health Narrow Network |
$3.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.44
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$119.70
|
|
|
Service Code
|
NDC 00054008813
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Aetna Commercial |
$107.73
|
| Rate for Payer: ASR ASR |
$116.11
|
| Rate for Payer: ASR Commercial |
$116.11
|
| Rate for Payer: BCBS Trust/PPO |
$97.54
|
| Rate for Payer: BCN Commercial |
$92.80
|
| Rate for Payer: Cash Price |
$95.76
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$119.70
|
| Rate for Payer: Healthscope Whirlpool |
$116.11
|
| Rate for Payer: Mclaren Commercial |
$107.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.74
|
| Rate for Payer: Nomi Health Commercial |
$98.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.34
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$507.84
|
|
|
Service Code
|
NDC 00054008826
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$330.10 |
| Max. Negotiated Rate |
$507.84 |
| Rate for Payer: Aetna Commercial |
$457.06
|
| Rate for Payer: ASR ASR |
$492.60
|
| Rate for Payer: ASR Commercial |
$492.60
|
| Rate for Payer: BCBS Trust/PPO |
$413.84
|
| Rate for Payer: BCN Commercial |
$393.73
|
| Rate for Payer: Cash Price |
$406.27
|
| Rate for Payer: Cofinity Commercial |
$477.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.27
|
| Rate for Payer: Healthscope Commercial |
$507.84
|
| Rate for Payer: Healthscope Whirlpool |
$492.60
|
| Rate for Payer: Mclaren Commercial |
$457.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Nomi Health Commercial |
$416.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.90
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
OP
|
$565.44
|
|
|
Service Code
|
NDC 00781208102
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$226.18 |
| Max. Negotiated Rate |
$565.44 |
| Rate for Payer: Aetna Commercial |
$508.90
|
| Rate for Payer: Aetna Medicare |
$282.72
|
| Rate for Payer: ASR ASR |
$548.48
|
| Rate for Payer: ASR Commercial |
$548.48
|
| Rate for Payer: BCBS Complete |
$226.18
|
| Rate for Payer: BCBS Trust/PPO |
$463.04
|
| Rate for Payer: BCN Commercial |
$438.39
|
| Rate for Payer: Cash Price |
$452.35
|
| Rate for Payer: Cofinity Commercial |
$531.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.35
|
| Rate for Payer: Healthscope Commercial |
$565.44
|
| Rate for Payer: Healthscope Whirlpool |
$548.48
|
| Rate for Payer: Mclaren Commercial |
$508.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.62
|
| Rate for Payer: Nomi Health Commercial |
$463.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$495.44
|
| Rate for Payer: Priority Health Narrow Network |
$396.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.59
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$39.34
|
|
|
Service Code
|
NDC 76329330401
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$39.34 |
| Rate for Payer: Aetna Commercial |
$35.41
|
| Rate for Payer: Aetna Medicare |
$19.67
|
| Rate for Payer: ASR ASR |
$38.16
|
| Rate for Payer: ASR Commercial |
$38.16
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: BCBS Trust/PPO |
$32.22
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$39.34
|
| Rate for Payer: Healthscope Whirlpool |
$38.16
|
| Rate for Payer: Mclaren Commercial |
$35.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Nomi Health Commercial |
$32.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.47
|
| Rate for Payer: Priority Health Narrow Network |
$27.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.62
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
NDC 64253090030
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.24 |
| Max. Negotiated Rate |
$33.11 |
| Rate for Payer: Aetna Commercial |
$29.80
|
| Rate for Payer: Aetna Medicare |
$16.56
|
| Rate for Payer: ASR ASR |
$32.12
|
| Rate for Payer: ASR Commercial |
$32.12
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$27.11
|
| Rate for Payer: BCN Commercial |
$25.67
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$33.11
|
| Rate for Payer: Healthscope Whirlpool |
$32.12
|
| Rate for Payer: Mclaren Commercial |
$29.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.01
|
| Rate for Payer: Priority Health Narrow Network |
$23.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.14
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
NDC 64253090036
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.24 |
| Max. Negotiated Rate |
$33.11 |
| Rate for Payer: Aetna Commercial |
$29.80
|
| Rate for Payer: Aetna Medicare |
$16.56
|
| Rate for Payer: ASR ASR |
$32.12
|
| Rate for Payer: ASR Commercial |
$32.12
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$27.11
|
| Rate for Payer: BCN Commercial |
$25.67
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$33.11
|
| Rate for Payer: Healthscope Whirlpool |
$32.12
|
| Rate for Payer: Mclaren Commercial |
$29.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.01
|
| Rate for Payer: Priority Health Narrow Network |
$23.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.14
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$70.53
|
|
|
Service Code
|
NDC 00409492834
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$70.53 |
| Rate for Payer: Aetna Commercial |
$63.48
|
| Rate for Payer: Aetna Medicare |
$35.26
|
| Rate for Payer: ASR ASR |
$68.41
|
| Rate for Payer: ASR Commercial |
$68.41
|
| Rate for Payer: BCBS Complete |
$28.21
|
| Rate for Payer: BCBS Trust/PPO |
$57.76
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$66.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.42
|
| Rate for Payer: Healthscope Commercial |
$70.53
|
| Rate for Payer: Healthscope Whirlpool |
$68.41
|
| Rate for Payer: Mclaren Commercial |
$63.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.95
|
| Rate for Payer: Nomi Health Commercial |
$57.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.80
|
| Rate for Payer: Priority Health Narrow Network |
$49.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.07
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$52.20
|
|
|
Service Code
|
NDC 00409163110
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.88 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$46.98
|
| Rate for Payer: Aetna Medicare |
$26.10
|
| Rate for Payer: ASR ASR |
$50.63
|
| Rate for Payer: ASR Commercial |
$50.63
|
| Rate for Payer: BCBS Complete |
$20.88
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$40.47
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cofinity Commercial |
$49.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Healthscope Whirlpool |
$50.63
|
| Rate for Payer: Mclaren Commercial |
$46.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.74
|
| Rate for Payer: Priority Health Narrow Network |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.94
|
|
