|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$24.09
|
|
|
Service Code
|
NDC 39822420001
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$8.91
|
| Rate for Payer: ASR ASR |
$23.36
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS Trust/PPO |
$19.86
|
| Rate for Payer: BCN Commercial |
$19.86
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$22.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Healthscope Whirlpool |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$21.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.47
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.11
|
| Rate for Payer: Priority Health Narrow Network |
$16.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$24.65
|
|
|
Service Code
|
NDC 409955849
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: Aetna Commercial |
$22.18
|
| Rate for Payer: ASR ASR |
$23.91
|
| Rate for Payer: BCBS Trust/PPO |
$20.24
|
| Rate for Payer: BCN Commercial |
$20.24
|
| Rate for Payer: Cash Price |
$19.72
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.72
|
| Rate for Payer: Healthscope Commercial |
$23.91
|
| Rate for Payer: Healthscope Whirlpool |
$24.65
|
| Rate for Payer: Mclaren Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.95
|
| Rate for Payer: Nomi Health Commercial |
$20.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.69
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$22.78
|
|
|
Service Code
|
NDC 39822420005
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Medicare |
$8.43
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS Trust/PPO |
$18.79
|
| Rate for Payer: BCN Commercial |
$18.79
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Whirlpool |
$22.78
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.96
|
| Rate for Payer: Priority Health Narrow Network |
$15.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$22.78
|
|
|
Service Code
|
NDC 39822420006
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.09 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: BCBS Trust/PPO |
$18.71
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Whirlpool |
$22.78
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
NDC 39822420002
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$24.09 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: ASR ASR |
$23.36
|
| Rate for Payer: BCBS Trust/PPO |
$19.78
|
| Rate for Payer: BCN Commercial |
$19.78
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$22.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Healthscope Whirlpool |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.47
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.20
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$28.97
|
|
|
Service Code
|
NDC 67457022899
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.72 |
| Max. Negotiated Rate |
$28.97 |
| Rate for Payer: Aetna Commercial |
$26.07
|
| Rate for Payer: Aetna Medicare |
$10.72
|
| Rate for Payer: ASR ASR |
$28.10
|
| Rate for Payer: BCBS Complete |
$11.59
|
| Rate for Payer: BCBS Trust/PPO |
$23.89
|
| Rate for Payer: BCN Commercial |
$23.89
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$27.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$28.10
|
| Rate for Payer: Healthscope Whirlpool |
$28.97
|
| Rate for Payer: Mclaren Commercial |
$26.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25.38
|
| Rate for Payer: Priority Health Narrow Network |
$20.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.49
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$22.78
|
|
|
Service Code
|
NDC 39822420005
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.09 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: BCBS Trust/PPO |
$18.71
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Whirlpool |
$22.78
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROCURONIUM 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$22.78
|
|
|
Service Code
|
NDC 39822420006
|
| Hospital Charge Code |
163721
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Medicare |
$8.43
|
| Rate for Payer: ASR ASR |
$22.10
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS Trust/PPO |
$18.79
|
| Rate for Payer: BCN Commercial |
$18.79
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$22.10
|
| Rate for Payer: Healthscope Whirlpool |
$22.78
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Nomi Health Commercial |
$18.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.96
|
| Rate for Payer: Priority Health Narrow Network |
$15.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.05
|
|
|
ROFLUMILAST 500 MCG TABLET
|
Facility
|
IP
|
$79.52
|
|
|
Service Code
|
NDC 59651027530
|
| Hospital Charge Code |
152640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.64 |
| Max. Negotiated Rate |
$79.52 |
| Rate for Payer: Aetna Commercial |
$71.56
|
| Rate for Payer: ASR ASR |
$77.13
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$65.30
|
| Rate for Payer: Cash Price |
$63.61
|
| Rate for Payer: Cofinity Commercial |
$74.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.61
|
| Rate for Payer: Healthscope Commercial |
$77.13
|
| Rate for Payer: Healthscope Whirlpool |
$79.52
|
| Rate for Payer: Mclaren Commercial |
$71.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.59
|
| Rate for Payer: Nomi Health Commercial |
$65.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.97
|
|
|
ROFLUMILAST 500 MCG TABLET
|
Facility
|
OP
|
$79.52
|
|
|
Service Code
|
NDC 59651027530
|
| Hospital Charge Code |
152640
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.42 |
| Max. Negotiated Rate |
$79.52 |
| Rate for Payer: Aetna Commercial |
$71.56
|
| Rate for Payer: Aetna Medicare |
$29.42
|
| Rate for Payer: ASR ASR |
$77.13
|
| Rate for Payer: BCBS Complete |
$31.81
|
| Rate for Payer: BCBS Trust/PPO |
$65.56
|
| Rate for Payer: BCN Commercial |
$65.56
|
| Rate for Payer: Cash Price |
$63.61
|
| Rate for Payer: Cofinity Commercial |
$74.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.61
|
| Rate for Payer: Healthscope Commercial |
$77.13
|
| Rate for Payer: Healthscope Whirlpool |
$79.52
|
| Rate for Payer: Mclaren Commercial |
$71.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.59
|
| Rate for Payer: Nomi Health Commercial |
$65.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.67
|
| Rate for Payer: Priority Health Narrow Network |
$55.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.97
|
|
|
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$11,921.56
|
|
|
Service Code
|
HCPCS J2802
|
| Hospital Charge Code |
93566
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$11,921.56 |
| Rate for Payer: Aetna Commercial |
$10,729.40
|
| Rate for Payer: Aetna Medicare |
$11.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.89
|
| Rate for Payer: ASR ASR |
$11,563.91
|
| Rate for Payer: BCBS Complete |
$6.10
|
| Rate for Payer: BCBS MAPPO |
$11.11
|
| Rate for Payer: BCBS Trust/PPO |
$9,829.33
|
| Rate for Payer: BCN Commercial |
$9,829.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.11
|
| Rate for Payer: Cash Price |
$9,537.25
|
| Rate for Payer: Cash Price |
$9,537.25
|
| Rate for Payer: Cofinity Commercial |
$11,206.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,537.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.11
|
| Rate for Payer: Healthscope Commercial |
$11,563.91
|
| Rate for Payer: Healthscope Whirlpool |
$11,921.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.11
|
| Rate for Payer: Mclaren Commercial |
$10,729.40
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Mclaren Medicare |
$11.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.67
|
| Rate for Payer: Meridian Medicaid |
$6.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,133.33
|
| Rate for Payer: Nomi Health Commercial |
$9,775.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,941.17
|
| Rate for Payer: PACE Medicare |
$10.55
|
| Rate for Payer: PACE SWMI |
$11.11
|
| Rate for Payer: PHP Commercial |
$12.22
|
| Rate for Payer: PHP Medicaid |
$5.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11.46
|
| Rate for Payer: Priority Health Medicare |
$11.11
|
| Rate for Payer: Priority Health Narrow Network |
$9.17
|
| Rate for Payer: Railroad Medicare Medicare |
$11.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,490.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.11
|
| Rate for Payer: UHC Exchange |
$17.22
|
| Rate for Payer: UHC Medicaid |
$5.81
|
| Rate for Payer: UHCCP DNSP |
$11.11
|
| Rate for Payer: UHCCP Medicaid |
$5.81
|
| Rate for Payer: VA VA |
$11.11
|
|
|
ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$11,921.56
|
|
|
Service Code
|
HCPCS J2802
|
| Hospital Charge Code |
93566
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8,941.17 |
| Max. Negotiated Rate |
$11,921.56 |
| Rate for Payer: Aetna Commercial |
$10,729.40
|
| Rate for Payer: ASR ASR |
$11,563.91
|
| Rate for Payer: BCBS Trust/PPO |
$9,789.99
|
| Rate for Payer: BCN Commercial |
$9,789.99
|
| Rate for Payer: Cash Price |
$9,537.25
|
| Rate for Payer: Cofinity Commercial |
$11,206.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,537.25
|
| Rate for Payer: Healthscope Commercial |
$11,563.91
|
| Rate for Payer: Healthscope Whirlpool |
$11,921.56
|
| Rate for Payer: Mclaren Commercial |
$10,729.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,133.33
|
| Rate for Payer: Nomi Health Commercial |
$9,775.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,941.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,490.97
|
|
|
ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$4,005.98
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
190169
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,004.49 |
| Max. Negotiated Rate |
$4,005.98 |
| Rate for Payer: Aetna Commercial |
$3,605.38
|
| Rate for Payer: Aetna Commercial |
$3,974.53
|
| Rate for Payer: ASR ASR |
$3,885.80
|
| Rate for Payer: ASR ASR |
$4,283.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,289.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,626.54
|
| Rate for Payer: BCN Commercial |
$3,289.71
|
| Rate for Payer: BCN Commercial |
$3,626.54
|
| Rate for Payer: Cash Price |
$3,532.92
|
| Rate for Payer: Cash Price |
$3,204.79
|
| Rate for Payer: Cofinity Commercial |
$4,151.18
|
| Rate for Payer: Cofinity Commercial |
$3,765.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,204.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,532.92
|
| Rate for Payer: Healthscope Commercial |
$3,885.80
|
| Rate for Payer: Healthscope Commercial |
$4,283.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,416.15
|
| Rate for Payer: Healthscope Whirlpool |
$4,005.98
|
| Rate for Payer: Mclaren Commercial |
$3,974.53
|
| Rate for Payer: Mclaren Commercial |
$3,605.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,753.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,405.09
|
| Rate for Payer: Nomi Health Commercial |
$3,621.24
|
| Rate for Payer: Nomi Health Commercial |
$3,284.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,004.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,312.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,886.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,525.27
|
|
|
ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$4,005.98
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
190169
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$4,005.98 |
| Rate for Payer: Aetna Commercial |
$3,605.38
|
| Rate for Payer: Aetna Commercial |
$3,974.53
|
| Rate for Payer: Aetna Medicare |
$12.19
|
| Rate for Payer: Aetna Medicare |
$12.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.24
|
| Rate for Payer: ASR ASR |
$3,885.80
|
| Rate for Payer: ASR ASR |
$4,283.66
|
| Rate for Payer: BCBS Complete |
$6.69
|
| Rate for Payer: BCBS Complete |
$6.69
|
| Rate for Payer: BCBS MAPPO |
$12.19
|
| Rate for Payer: BCBS MAPPO |
$12.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,641.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,302.93
|
| Rate for Payer: BCN Commercial |
$3,641.11
|
| Rate for Payer: BCN Commercial |
$3,302.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.19
|
| Rate for Payer: BCN Medicare Advantage |
$12.19
|
| Rate for Payer: Cash Price |
$3,204.79
|
| Rate for Payer: Cash Price |
$3,204.79
|
| Rate for Payer: Cash Price |
$3,532.92
|
| Rate for Payer: Cash Price |
$3,532.92
|
| Rate for Payer: Cofinity Commercial |
$3,765.62
|
| Rate for Payer: Cofinity Commercial |
$4,151.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,532.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,204.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.19
|
| Rate for Payer: Healthscope Commercial |
$3,885.80
|
| Rate for Payer: Healthscope Commercial |
$4,283.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,005.98
|
| Rate for Payer: Healthscope Whirlpool |
$4,416.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.19
|
| Rate for Payer: Mclaren Commercial |
$3,974.53
|
| Rate for Payer: Mclaren Commercial |
$3,605.38
|
| Rate for Payer: Mclaren Medicaid |
$12.19
|
| Rate for Payer: Mclaren Medicaid |
$12.19
|
| Rate for Payer: Mclaren Medicare |
$12.19
|
| Rate for Payer: Mclaren Medicare |
$12.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.80
|
| Rate for Payer: Meridian Medicaid |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,405.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,753.72
|
| Rate for Payer: Nomi Health Commercial |
$3,621.24
|
| Rate for Payer: Nomi Health Commercial |
$3,284.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,004.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,312.11
|
| Rate for Payer: PACE Medicare |
$11.58
|
| Rate for Payer: PACE Medicare |
$11.58
|
| Rate for Payer: PACE SWMI |
$12.19
|
| Rate for Payer: PACE SWMI |
$12.19
|
| Rate for Payer: PHP Commercial |
$13.41
|
| Rate for Payer: PHP Commercial |
$13.41
|
| Rate for Payer: PHP Medicaid |
$6.53
|
| Rate for Payer: PHP Medicaid |
$6.53
|
| Rate for Payer: PHP Medicare Advantage |
$12.19
|
| Rate for Payer: PHP Medicare Advantage |
$12.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.57
|
| Rate for Payer: Priority Health Medicare |
$12.19
|
| Rate for Payer: Priority Health Medicare |
$12.19
|
| Rate for Payer: Priority Health Narrow Network |
$10.06
|
| Rate for Payer: Priority Health Narrow Network |
$10.06
|
| Rate for Payer: Railroad Medicare Medicare |
$12.19
|
| Rate for Payer: Railroad Medicare Medicare |
$12.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,886.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,525.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.19
|
| Rate for Payer: UHC Exchange |
$18.89
|
| Rate for Payer: UHC Exchange |
$18.89
|
| Rate for Payer: UHC Medicaid |
$6.38
|
| Rate for Payer: UHC Medicaid |
$6.38
|
| Rate for Payer: UHCCP DNSP |
$12.19
|
| Rate for Payer: UHCCP DNSP |
$12.19
|
| Rate for Payer: UHCCP Medicaid |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$6.38
|
| Rate for Payer: VA VA |
$12.19
|
| Rate for Payer: VA VA |
$12.19
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
OP
|
$185.73
|
|
|
Service Code
|
NDC 50268074115
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.72 |
| Max. Negotiated Rate |
$185.72 |
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: Aetna Medicare |
$68.72
|
| Rate for Payer: ASR ASR |
$180.15
|
| Rate for Payer: BCBS Complete |
$74.29
|
| Rate for Payer: BCBS Trust/PPO |
$153.13
|
| Rate for Payer: BCN Commercial |
$153.13
|
| Rate for Payer: Cash Price |
$148.58
|
| Rate for Payer: Cofinity Commercial |
$174.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.58
|
| Rate for Payer: Healthscope Commercial |
$180.15
|
| Rate for Payer: Healthscope Whirlpool |
$185.72
|
| Rate for Payer: Mclaren Commercial |
$167.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.87
|
| Rate for Payer: Nomi Health Commercial |
$152.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.73
|
| Rate for Payer: Priority Health Narrow Network |
$130.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.44
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
IP
|
$3.72
|
|
|
Service Code
|
NDC 50268074111
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: ASR ASR |
$3.60
|
| Rate for Payer: BCBS Trust/PPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.97
|
| Rate for Payer: Healthscope Commercial |
$3.60
|
| Rate for Payer: Healthscope Whirlpool |
$3.71
|
| Rate for Payer: Mclaren Commercial |
$3.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.16
|
| Rate for Payer: Nomi Health Commercial |
$3.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.27
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
IP
|
$185.73
|
|
|
Service Code
|
NDC 50268074115
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.29 |
| Max. Negotiated Rate |
$185.72 |
| Rate for Payer: Aetna Commercial |
$167.15
|
| Rate for Payer: ASR ASR |
$180.15
|
| Rate for Payer: BCBS Trust/PPO |
$152.52
|
| Rate for Payer: BCN Commercial |
$152.52
|
| Rate for Payer: Cash Price |
$148.58
|
| Rate for Payer: Cofinity Commercial |
$174.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.58
|
| Rate for Payer: Healthscope Commercial |
$180.15
|
| Rate for Payer: Healthscope Whirlpool |
$185.72
|
| Rate for Payer: Mclaren Commercial |
$167.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.87
|
| Rate for Payer: Nomi Health Commercial |
$152.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.44
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
OP
|
$3.72
|
|
|
Service Code
|
NDC 50268074111
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.37 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna Medicare |
$1.37
|
| Rate for Payer: ASR ASR |
$3.60
|
| Rate for Payer: BCBS Complete |
$1.49
|
| Rate for Payer: BCBS Trust/PPO |
$3.06
|
| Rate for Payer: BCN Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.97
|
| Rate for Payer: Healthscope Commercial |
$3.60
|
| Rate for Payer: Healthscope Whirlpool |
$3.71
|
| Rate for Payer: Mclaren Commercial |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.16
|
| Rate for Payer: Nomi Health Commercial |
$3.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.26
|
| Rate for Payer: Priority Health Narrow Network |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.27
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
IP
|
$360.05
|
|
|
Service Code
|
NDC 904637461
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$270.04 |
| Max. Negotiated Rate |
$360.05 |
| Rate for Payer: Aetna Commercial |
$324.05
|
| Rate for Payer: ASR ASR |
$349.25
|
| Rate for Payer: BCBS Trust/PPO |
$295.67
|
| Rate for Payer: BCN Commercial |
$295.67
|
| Rate for Payer: Cash Price |
$288.04
|
| Rate for Payer: Cofinity Commercial |
$338.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.04
|
| Rate for Payer: Healthscope Commercial |
$349.25
|
| Rate for Payer: Healthscope Whirlpool |
$360.05
|
| Rate for Payer: Mclaren Commercial |
$324.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.04
|
| Rate for Payer: Nomi Health Commercial |
$295.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.84
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
OP
|
$360.05
|
|
|
Service Code
|
NDC 904637461
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.22 |
| Max. Negotiated Rate |
$360.05 |
| Rate for Payer: Aetna Commercial |
$324.05
|
| Rate for Payer: Aetna Medicare |
$133.22
|
| Rate for Payer: ASR ASR |
$349.25
|
| Rate for Payer: BCBS Complete |
$144.02
|
| Rate for Payer: BCBS Trust/PPO |
$296.86
|
| Rate for Payer: BCN Commercial |
$296.86
|
| Rate for Payer: Cash Price |
$288.04
|
| Rate for Payer: Cofinity Commercial |
$338.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.04
|
| Rate for Payer: Healthscope Commercial |
$349.25
|
| Rate for Payer: Healthscope Whirlpool |
$360.05
|
| Rate for Payer: Mclaren Commercial |
$324.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.04
|
| Rate for Payer: Nomi Health Commercial |
$295.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$315.48
|
| Rate for Payer: Priority Health Narrow Network |
$252.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.84
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) CUSTOM INJECTION
|
Facility
|
OP
|
$18.12
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
300612
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Aetna Commercial |
$16.31
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: ASR ASR |
$17.58
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.50
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Whirlpool |
$18.12
|
| Rate for Payer: Mclaren Commercial |
$16.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.40
|
| Rate for Payer: Nomi Health Commercial |
$14.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.95
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) CUSTOM INJECTION
|
Facility
|
IP
|
$18.12
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
300612
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Aetna Commercial |
$16.31
|
| Rate for Payer: ASR ASR |
$17.58
|
| Rate for Payer: BCBS Trust/PPO |
$14.88
|
| Rate for Payer: BCN Commercial |
$14.88
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.50
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Whirlpool |
$18.12
|
| Rate for Payer: Mclaren Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.40
|
| Rate for Payer: Nomi Health Commercial |
$14.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.95
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
OP
|
$72.40
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18192
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$72.40 |
| Rate for Payer: Aetna Commercial |
$65.16
|
| Rate for Payer: Aetna Commercial |
$132.48
|
| Rate for Payer: Aetna Commercial |
$16.31
|
| Rate for Payer: Aetna Commercial |
$10.98
|
| Rate for Payer: Aetna Medicare |
$4.51
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: Aetna Medicare |
$54.46
|
| Rate for Payer: ASR ASR |
$17.58
|
| Rate for Payer: ASR ASR |
$142.78
|
| Rate for Payer: ASR ASR |
$11.83
|
| Rate for Payer: ASR ASR |
$70.23
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS Complete |
$4.88
|
| Rate for Payer: BCBS Complete |
$28.96
|
| Rate for Payer: BCBS Complete |
$58.88
|
| Rate for Payer: BCBS Trust/PPO |
$121.37
|
| Rate for Payer: BCBS Trust/PPO |
$59.69
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$59.69
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Commercial |
$10.06
|
| Rate for Payer: BCN Commercial |
$121.37
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cash Price |
$57.92
|
| Rate for Payer: Cash Price |
$117.76
|
| Rate for Payer: Cash Price |
$117.76
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$57.92
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cofinity Commercial |
$68.06
|
| Rate for Payer: Cofinity Commercial |
$11.47
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Commercial |
$138.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.50
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Healthscope Commercial |
$11.83
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Whirlpool |
$12.20
|
| Rate for Payer: Healthscope Whirlpool |
$18.12
|
| Rate for Payer: Healthscope Whirlpool |
$72.40
|
| Rate for Payer: Healthscope Whirlpool |
$147.20
|
| Rate for Payer: Mclaren Commercial |
$16.31
|
| Rate for Payer: Mclaren Commercial |
$132.48
|
| Rate for Payer: Mclaren Commercial |
$10.98
|
| Rate for Payer: Mclaren Commercial |
$65.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.54
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Nomi Health Commercial |
$14.86
|
| Rate for Payer: Nomi Health Commercial |
$59.37
|
| Rate for Payer: Nomi Health Commercial |
$120.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.05
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: Priority Health Narrow Network |
$0.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.54
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
IP
|
$18.12
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18192
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Aetna Commercial |
$16.31
|
| Rate for Payer: Aetna Commercial |
$132.48
|
| Rate for Payer: Aetna Commercial |
$65.16
|
| Rate for Payer: Aetna Commercial |
$10.98
|
| Rate for Payer: ASR ASR |
$70.23
|
| Rate for Payer: ASR ASR |
$17.58
|
| Rate for Payer: ASR ASR |
$142.78
|
| Rate for Payer: ASR ASR |
$11.83
|
| Rate for Payer: BCBS Trust/PPO |
$14.88
|
| Rate for Payer: BCBS Trust/PPO |
$10.02
|
| Rate for Payer: BCBS Trust/PPO |
$120.88
|
| Rate for Payer: BCBS Trust/PPO |
$59.45
|
| Rate for Payer: BCN Commercial |
$10.02
|
| Rate for Payer: BCN Commercial |
$59.45
|
| Rate for Payer: BCN Commercial |
$120.88
|
| Rate for Payer: BCN Commercial |
$14.88
|
| Rate for Payer: Cash Price |
$57.92
|
| Rate for Payer: Cash Price |
$117.76
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Commercial |
$11.47
|
| Rate for Payer: Cofinity Commercial |
$68.06
|
| Rate for Payer: Cofinity Commercial |
$138.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$11.83
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Healthscope Whirlpool |
$18.12
|
| Rate for Payer: Healthscope Whirlpool |
$72.40
|
| Rate for Payer: Healthscope Whirlpool |
$12.20
|
| Rate for Payer: Healthscope Whirlpool |
$147.20
|
| Rate for Payer: Mclaren Commercial |
$10.98
|
| Rate for Payer: Mclaren Commercial |
$65.16
|
| Rate for Payer: Mclaren Commercial |
$132.48
|
| Rate for Payer: Mclaren Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Nomi Health Commercial |
$120.70
|
| Rate for Payer: Nomi Health Commercial |
$59.37
|
| Rate for Payer: Nomi Health Commercial |
$14.86
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.71
|
|
|
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
IP
|
$20.69
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
153276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.52 |
| Max. Negotiated Rate |
$20.69 |
| Rate for Payer: Aetna Commercial |
$18.62
|
| Rate for Payer: Aetna Commercial |
$26.11
|
| Rate for Payer: Aetna Commercial |
$22.35
|
| Rate for Payer: ASR ASR |
$28.14
|
| Rate for Payer: ASR ASR |
$20.07
|
| Rate for Payer: ASR ASR |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$23.83
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCBS Trust/PPO |
$20.39
|
| Rate for Payer: BCN Commercial |
$20.39
|
| Rate for Payer: BCN Commercial |
$16.99
|
| Rate for Payer: BCN Commercial |
$23.83
|
| Rate for Payer: Cash Price |
$23.21
|
| Rate for Payer: Cash Price |
$16.55
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Cofinity Commercial |
$19.45
|
| Rate for Payer: Cofinity Commercial |
$23.34
|
| Rate for Payer: Cofinity Commercial |
$27.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.86
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$20.07
|
| Rate for Payer: Healthscope Commercial |
$28.14
|
| Rate for Payer: Healthscope Whirlpool |
$24.83
|
| Rate for Payer: Healthscope Whirlpool |
$29.01
|
| Rate for Payer: Healthscope Whirlpool |
$20.69
|
| Rate for Payer: Mclaren Commercial |
$22.35
|
| Rate for Payer: Mclaren Commercial |
$18.62
|
| Rate for Payer: Mclaren Commercial |
$26.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: Nomi Health Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$23.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.21
|
|
