|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
NDC 409710169
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.07
|
| Rate for Payer: ASR ASR |
$71.21
|
| Rate for Payer: BCBS Trust/PPO |
$60.29
|
| Rate for Payer: BCN Commercial |
$60.29
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$71.21
|
| Rate for Payer: Healthscope Whirlpool |
$73.42
|
| Rate for Payer: Mclaren Commercial |
$66.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.40
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.61
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
NDC 409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.07
|
| Rate for Payer: ASR ASR |
$71.21
|
| Rate for Payer: BCBS Trust/PPO |
$60.29
|
| Rate for Payer: BCN Commercial |
$60.29
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$71.21
|
| Rate for Payer: Healthscope Whirlpool |
$73.42
|
| Rate for Payer: Mclaren Commercial |
$66.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.40
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.61
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
NDC 409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.16 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.07
|
| Rate for Payer: Aetna Medicare |
$27.16
|
| Rate for Payer: ASR ASR |
$71.21
|
| Rate for Payer: BCBS Complete |
$29.37
|
| Rate for Payer: BCBS Trust/PPO |
$60.53
|
| Rate for Payer: BCN Commercial |
$60.53
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$71.21
|
| Rate for Payer: Healthscope Whirlpool |
$73.42
|
| Rate for Payer: Mclaren Commercial |
$66.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.40
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.33
|
| Rate for Payer: Priority Health Narrow Network |
$51.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.61
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
NDC 409710169
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.16 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.07
|
| Rate for Payer: Aetna Medicare |
$27.16
|
| Rate for Payer: ASR ASR |
$71.21
|
| Rate for Payer: BCBS Complete |
$29.37
|
| Rate for Payer: BCBS Trust/PPO |
$60.53
|
| Rate for Payer: BCN Commercial |
$60.53
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$71.21
|
| Rate for Payer: Healthscope Whirlpool |
$73.42
|
| Rate for Payer: Mclaren Commercial |
$66.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.40
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.33
|
| Rate for Payer: Priority Health Narrow Network |
$51.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.61
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: BCBS Trust/PPO |
$52.39
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$52.39
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Healthscope Whirlpool |
$63.80
|
| Rate for Payer: Healthscope Whirlpool |
$55.99
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Mclaren Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$45.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.14
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$63.80
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$63.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: Aetna Medicare |
$20.72
|
| Rate for Payer: Aetna Medicare |
$23.61
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$52.60
|
| Rate for Payer: BCBS Trust/PPO |
$46.16
|
| Rate for Payer: BCN Commercial |
$46.16
|
| Rate for Payer: BCN Commercial |
$52.60
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Healthscope Whirlpool |
$63.80
|
| Rate for Payer: Healthscope Whirlpool |
$55.99
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Mclaren Commercial |
$50.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Nomi Health Commercial |
$45.91
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.69
|
| Rate for Payer: Priority Health Narrow Network |
$0.55
|
| Rate for Payer: Priority Health Narrow Network |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.14
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.31 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$52.40
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: BCBS Trust/PPO |
$51.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.14
|
| Rate for Payer: BCBS Trust/PPO |
$47.82
|
| Rate for Payer: BCN Commercial |
$47.82
|
| Rate for Payer: BCN Commercial |
$44.14
|
| Rate for Payer: BCN Commercial |
$51.49
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.73
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$56.48
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Whirlpool |
$58.23
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Mclaren Commercial |
$52.40
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$67.19
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.39 |
| Max. Negotiated Rate |
$67.19 |
| Rate for Payer: Aetna Commercial |
$60.47
|
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR ASR |
$65.17
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$55.17
|
| Rate for Payer: BCBS Trust/PPO |
$39.29
|
| Rate for Payer: BCBS Trust/PPO |
$52.39
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCN Commercial |
$39.29
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: BCN Commercial |
$52.39
|
| Rate for Payer: BCN Commercial |
$55.17
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$67.19
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Healthscope Whirlpool |
$63.80
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Mclaren Commercial |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Commercial |
$52.40
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$21.54
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Aetna Medicare |
$23.20
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCBS Trust/PPO |
$48.01
|
| Rate for Payer: BCBS Trust/PPO |
$51.70
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Commercial |
$48.01
|
| Rate for Payer: BCN Commercial |
$51.70
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$54.73
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$58.23
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$52.40
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Commercial |
$60.47
|
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: Aetna Medicare |
$17.70
|
| Rate for Payer: Aetna Medicare |
$25.87
|
| Rate for Payer: Aetna Medicare |
$24.86
|
| Rate for Payer: Aetna Medicare |
$23.61
|
| Rate for Payer: ASR ASR |
$65.17
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: BCBS Complete |
$26.87
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$52.60
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCBS Trust/PPO |
$55.39
|
| Rate for Payer: BCBS Trust/PPO |
$39.45
|
| Rate for Payer: BCN Commercial |
$57.65
|
| Rate for Payer: BCN Commercial |
$55.39
|
| Rate for Payer: BCN Commercial |
$39.45
|
| Rate for Payer: BCN Commercial |
$52.60
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Commercial |
$46.41
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Healthscope Whirlpool |
$47.85
|
| Rate for Payer: Healthscope Whirlpool |
$67.19
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$63.80
|
| Rate for Payer: Mclaren Commercial |
$60.47
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.14
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$67.19
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.39 |
| Max. Negotiated Rate |
$67.19 |
| Rate for Payer: Aetna Commercial |
$60.47
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR ASR |
$65.17
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCBS Trust/PPO |
$55.17
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: BCN Commercial |
$55.17
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.19
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Commercial |
$52.40
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$21.54
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Aetna Medicare |
$23.20
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCBS Trust/PPO |
$48.01
|
| Rate for Payer: BCBS Trust/PPO |
$51.70
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Commercial |
$48.01
|
| Rate for Payer: BCN Commercial |
$51.70
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$54.73
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$58.23
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$52.40
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$60.47
|
| Rate for Payer: Aetna Medicare |
$24.86
|
| Rate for Payer: Aetna Medicare |
$25.87
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR ASR |
$65.17
|
| Rate for Payer: BCBS Complete |
$26.87
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.65
|
| Rate for Payer: BCBS Trust/PPO |
$55.39
|
| Rate for Payer: BCN Commercial |
$55.39
|
| Rate for Payer: BCN Commercial |
$57.65
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$67.82
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Healthscope Whirlpool |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.19
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$60.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: Aetna Medicare |
$20.72
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$46.16
|
| Rate for Payer: BCN Commercial |
$46.16
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Healthscope Whirlpool |
$55.99
|
| Rate for Payer: Mclaren Commercial |
$50.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Nomi Health Commercial |
$45.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.69
|
| Rate for Payer: Priority Health Narrow Network |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Healthscope Whirlpool |
$55.99
|
| Rate for Payer: Mclaren Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.59
|
| Rate for Payer: Nomi Health Commercial |
$45.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.31 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$52.40
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: BCBS Trust/PPO |
$51.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.14
|
| Rate for Payer: BCBS Trust/PPO |
$47.82
|
| Rate for Payer: BCN Commercial |
$47.82
|
| Rate for Payer: BCN Commercial |
$44.14
|
| Rate for Payer: BCN Commercial |
$51.49
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.73
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Healthscope Commercial |
$56.48
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Whirlpool |
$58.23
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Mclaren Commercial |
$52.40
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
NDC 338004803
|
| Hospital Charge Code |
11403
|
|
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
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
NDC 338004803
|
| Hospital Charge Code |
11403
|
|
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
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 338004727
|
| Hospital Charge Code |
11403
|
|
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
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
OP
|
$95.70
|
|
|
Service Code
|
NDC 338004727
|
| Hospital Charge Code |
11403
|
|
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
|
|
|
SODIUM CHLORIDE 0.9 % IV 1000 ML BAG (FOR BOLUS OR FLUSH)
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301142
|
|
Hospital Revenue Code
|
636
|
| 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
|
|
|
SODIUM CHLORIDE 0.9 % IV 1000 ML BAG (FOR BOLUS OR FLUSH)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| 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 |
$2.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % IV ADDITIONAL SOLUTION
|
Facility
|
OP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180543
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Aetna Medicare |
$23.20
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$51.70
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Commercial |
$51.70
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.33
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
|
|
SODIUM CHLORIDE 0.9 % IV ADDITIONAL SOLUTION
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180543
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.31 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.37
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: ASR ASR |
$60.82
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: BCBS Trust/PPO |
$51.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.14
|
| Rate for Payer: BCN Commercial |
$51.49
|
| Rate for Payer: BCN Commercial |
$44.14
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$60.82
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$53.75
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$48.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$44.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
400291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| 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 |
$2.06
|
| Rate for Payer: Priority Health Narrow Network |
$1.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
