|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 1.5 MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180423
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCN Commercial |
$54.21
|
| 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 |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCN Commercial |
$54.21
|
| 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 |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$56.98
|
| Rate for Payer: BCN Commercial |
$54.21
|
| 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 |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$41.47
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$41.47 |
| Rate for Payer: Aetna Commercial |
$37.32
|
| Rate for Payer: ASR ASR |
$40.23
|
| Rate for Payer: ASR Commercial |
$40.23
|
| Rate for Payer: BCBS Trust/PPO |
$33.79
|
| Rate for Payer: BCN Commercial |
$32.15
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$38.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$41.47
|
| Rate for Payer: Healthscope Whirlpool |
$40.23
|
| Rate for Payer: Mclaren Commercial |
$37.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.25
|
| Rate for Payer: Nomi Health Commercial |
$34.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.49
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$41.47
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$41.47 |
| Rate for Payer: Aetna Commercial |
$37.32
|
| Rate for Payer: Aetna Medicare |
$20.74
|
| Rate for Payer: ASR ASR |
$40.23
|
| Rate for Payer: ASR Commercial |
$40.23
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$32.15
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$38.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$41.47
|
| Rate for Payer: Healthscope Whirlpool |
$40.23
|
| Rate for Payer: Mclaren Commercial |
$37.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.25
|
| Rate for Payer: Nomi Health Commercial |
$34.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.34
|
| Rate for Payer: Priority Health Narrow Network |
$29.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.49
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
NDC 00409710169
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.37 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.08
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: ASR ASR |
$71.22
|
| Rate for Payer: ASR Commercial |
$71.22
|
| Rate for Payer: BCBS Complete |
$29.37
|
| Rate for Payer: BCBS Trust/PPO |
$60.12
|
| Rate for Payer: BCN Commercial |
$56.92
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$73.42
|
| Rate for Payer: Healthscope Whirlpool |
$71.22
|
| Rate for Payer: Mclaren Commercial |
$66.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.33
|
| Rate for Payer: Priority Health Narrow Network |
$51.47
|
| 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 00409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.37 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.08
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: ASR ASR |
$71.22
|
| Rate for Payer: ASR Commercial |
$71.22
|
| Rate for Payer: BCBS Complete |
$29.37
|
| Rate for Payer: BCBS Trust/PPO |
$60.12
|
| Rate for Payer: BCN Commercial |
$56.92
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$73.42
|
| Rate for Payer: Healthscope Whirlpool |
$71.22
|
| Rate for Payer: Mclaren Commercial |
$66.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.33
|
| Rate for Payer: Priority Health Narrow Network |
$51.47
|
| 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 00409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$47.72 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.08
|
| Rate for Payer: ASR ASR |
$71.22
|
| Rate for Payer: ASR Commercial |
$71.22
|
| Rate for Payer: BCBS Trust/PPO |
$59.83
|
| Rate for Payer: BCN Commercial |
$56.92
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$73.42
|
| Rate for Payer: Healthscope Whirlpool |
$71.22
|
| Rate for Payer: Mclaren Commercial |
$66.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.72
|
| 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 00409710169
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$47.72 |
| Max. Negotiated Rate |
$73.42 |
| Rate for Payer: Aetna Commercial |
$66.08
|
| Rate for Payer: ASR ASR |
$71.22
|
| Rate for Payer: ASR Commercial |
$71.22
|
| Rate for Payer: BCBS Trust/PPO |
$59.83
|
| Rate for Payer: BCN Commercial |
$56.92
|
| Rate for Payer: Cash Price |
$58.73
|
| Rate for Payer: Cofinity Commercial |
$69.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$73.42
|
| Rate for Payer: Healthscope Whirlpool |
$71.22
|
| Rate for Payer: Mclaren Commercial |
$66.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.61
|
|
|
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 |
$2.05 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$23.92
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$46.41
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: ASR Commercial |
$61.89
|
| Rate for Payer: BCBS Complete |
$26.87
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$52.25
|
| Rate for Payer: BCBS Trust/PPO |
$39.18
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCN Commercial |
$37.10
|
| Rate for Payer: BCN Commercial |
$54.21
|
| Rate for Payer: BCN Commercial |
$49.46
|
| Rate for Payer: BCN Commercial |
$52.08
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$38.28
|
| 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 |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| 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 |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$63.80
|
| Rate for Payer: Healthscope Commercial |
$47.85
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Whirlpool |
$61.89
|
| Rate for Payer: Healthscope Whirlpool |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$65.16
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| Rate for Payer: Mclaren Commercial |
$60.46
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| 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
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: ASR Commercial |
$54.31
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$45.85
|
| Rate for Payer: BCN Commercial |
$43.41
|
| 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 |
$55.99
|
| Rate for Payer: Healthscope Whirlpool |
$54.31
|
| 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: Priority Health Cigna Priority Health |
$36.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.64
|
| Rate for Payer: Priority Health Narrow Network |
$0.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
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 |
$36.39 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: ASR Commercial |
$54.31
|
| Rate for Payer: BCBS Trust/PPO |
$45.63
|
| Rate for Payer: BCN Commercial |
$43.41
|
| 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 |
$55.99
|
| Rate for Payer: Healthscope Whirlpool |
$54.31
|
| 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: Priority Health Cigna Priority Health |
$36.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
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 |
$1.02 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: Aetna Medicare |
$26.88
|
| Rate for Payer: Aetna Medicare |
$29.12
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$56.48
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$51.35
|
| Rate for Payer: BCBS Trust/PPO |
$44.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.68
|
| Rate for Payer: BCN Commercial |
$45.15
|
| Rate for Payer: BCN Commercial |
$48.62
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| 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 |
$62.71
|
| Rate for Payer: Healthscope Commercial |
$58.23
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| Rate for Payer: Healthscope Whirlpool |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Mclaren Commercial |
$52.41
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Aetna Commercial |
$43.06
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR ASR |
$61.89
|
| Rate for Payer: ASR ASR |
$46.41
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: ASR Commercial |
$61.89
|
| Rate for Payer: ASR Commercial |
$46.41
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.99
|
| Rate for Payer: BCBS Trust/PPO |
$56.98
|
| Rate for Payer: BCBS Trust/PPO |
$51.99
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$54.21
|
| Rate for Payer: BCN Commercial |
$37.10
|
| Rate for Payer: BCN Commercial |
$49.46
|
| Rate for Payer: BCN Commercial |
$52.08
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$47.85
|
| Rate for Payer: Healthscope Commercial |
$63.80
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Commercial |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$65.16
|
| Rate for Payer: Healthscope Whirlpool |
$46.41
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$61.89
|
| Rate for Payer: Mclaren Commercial |
$43.06
|
| Rate for Payer: Mclaren Commercial |
$60.46
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$57.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Nomi Health Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$39.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$58.23
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$58.23 |
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$56.48
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: BCBS Trust/PPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: BCN Commercial |
$48.62
|
| Rate for Payer: BCN Commercial |
$45.15
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$58.23
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| Rate for Payer: Mclaren Commercial |
$52.41
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
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 |
$0.51 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: ASR Commercial |
$54.31
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$45.85
|
| Rate for Payer: BCN Commercial |
$43.41
|
| 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 |
$55.99
|
| Rate for Payer: Healthscope Whirlpool |
$54.31
|
| 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: Priority Health Cigna Priority Health |
$36.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.64
|
| Rate for Payer: Priority Health Narrow Network |
$0.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
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 |
$2.05 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Complete |
$26.87
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCN Commercial |
$52.08
|
| Rate for Payer: BCN Commercial |
$54.21
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| 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 |
$53.74
|
| Rate for Payer: Healthscope Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| Rate for Payer: Healthscope Whirlpool |
$65.16
|
| Rate for Payer: Mclaren Commercial |
$60.46
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.56
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| Rate for Payer: Priority Health Narrow Network |
$2.05
|
| 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 |
$1.02 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: Aetna Medicare |
$26.88
|
| Rate for Payer: Aetna Medicare |
$29.12
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$56.48
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$51.35
|
| Rate for Payer: BCBS Trust/PPO |
$44.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.68
|
| Rate for Payer: BCN Commercial |
$45.15
|
| Rate for Payer: BCN Commercial |
$48.62
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| 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 |
$62.71
|
| Rate for Payer: Healthscope Commercial |
$58.23
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| Rate for Payer: Healthscope Whirlpool |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Mclaren Commercial |
$52.41
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.28
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: Priority Health Narrow Network |
$1.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
|
|
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 |
$36.39 |
| Max. Negotiated Rate |
$55.99 |
| Rate for Payer: Aetna Commercial |
$50.39
|
| Rate for Payer: ASR ASR |
$54.31
|
| Rate for Payer: ASR Commercial |
$54.31
|
| Rate for Payer: BCBS Trust/PPO |
$45.63
|
| Rate for Payer: BCN Commercial |
$43.41
|
| 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 |
$55.99
|
| Rate for Payer: Healthscope Whirlpool |
$54.31
|
| 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: Priority Health Cigna Priority Health |
$36.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCBS Trust/PPO |
$56.98
|
| Rate for Payer: BCN Commercial |
$54.21
|
| Rate for Payer: BCN Commercial |
$52.08
|
| 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 |
$53.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Commercial |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$65.16
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| Rate for Payer: Mclaren Commercial |
$60.46
|
| Rate for Payer: Mclaren Commercial |
$62.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| 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
|
IP
|
$58.23
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$58.23 |
| Rate for Payer: Aetna Commercial |
$52.41
|
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$56.48
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$56.48
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: BCBS Trust/PPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: BCN Commercial |
$48.62
|
| Rate for Payer: BCN Commercial |
$45.15
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.16
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$54.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$58.23
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$56.48
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| Rate for Payer: Mclaren Commercial |
$52.41
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Mclaren Commercial |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
OP
|
$95.70
|
|
|
Service Code
|
NDC 00338004727
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$95.70 |
| Rate for Payer: Aetna Commercial |
$86.13
|
| Rate for Payer: Aetna Medicare |
$47.85
|
| Rate for Payer: ASR ASR |
$92.83
|
| Rate for Payer: ASR Commercial |
$92.83
|
| Rate for Payer: BCBS Complete |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.37
|
| Rate for Payer: BCN Commercial |
$74.20
|
| 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 |
$95.70
|
| Rate for Payer: Healthscope Whirlpool |
$92.83
|
| 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: Priority Health Cigna Priority Health |
$62.20
|
| Rate for Payer: 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 % IRRIGATION SOLUTION
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 00338004727
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$95.70 |
| Rate for Payer: Aetna Commercial |
$86.13
|
| Rate for Payer: ASR ASR |
$92.83
|
| Rate for Payer: ASR Commercial |
$92.83
|
| Rate for Payer: BCBS Trust/PPO |
$77.99
|
| Rate for Payer: BCN Commercial |
$74.20
|
| 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 |
$95.70
|
| Rate for Payer: Healthscope Whirlpool |
$92.83
|
| 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: Priority Health Cigna Priority Health |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.22
|
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
NDC 00338004803
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.97 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCN Commercial |
$54.21
|
| 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 |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: 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
|
$69.92
|
|
|
Service Code
|
NDC 00338004803
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$69.92 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: BCBS Trust/PPO |
$56.98
|
| Rate for Payer: BCN Commercial |
$54.21
|
| 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 |
$69.92
|
| Rate for Payer: Healthscope Whirlpool |
$67.82
|
| 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: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
|
