|
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 |
$22.40 |
| 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: 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 |
$49.06
|
| Rate for Payer: Priority Health Narrow Network |
$39.25
|
| 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 |
$65.16
|
| Rate for Payer: ASR ASR |
$67.82
|
| 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 |
$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 |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| 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
|
$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
|
$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
|
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
|
|
|
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
|
$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
|
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 % 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 |
$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 % 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 |
$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 % IV ADDITIONAL SOLUTION
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180543
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.50 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$26.88
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$44.02
|
| Rate for Payer: BCBS Trust/PPO |
$51.35
|
| 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 |
$50.16
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| 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 |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| 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 |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.95
|
| Rate for Payer: Priority Health Narrow Network |
$43.96
|
| Rate for Payer: Priority Health Narrow Network |
$37.68
|
| 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 % IV ADDITIONAL SOLUTION
|
Facility
|
IP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180543
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.76 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR ASR |
$60.83
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: ASR Commercial |
$60.83
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCBS Trust/PPO |
$51.10
|
| Rate for Payer: BCN Commercial |
$48.62
|
| Rate for Payer: BCN Commercial |
$41.67
|
| 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 |
$58.95
|
| 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 |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$60.83
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| 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 |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| 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
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
400291
|
|
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 % IV BOLUS
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
400291
|
|
Hospital Revenue Code
|
636
|
| 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 % IV BOLUS (CODE)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
163716
|
|
Hospital Revenue Code
|
636
|
| 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 % IV BOLUS (CODE)
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
163716
|
|
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 % IV - DKA
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
161519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.94 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % IV - DKA
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
161519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.50 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$48.38
|
| Rate for Payer: Aetna Medicare |
$26.88
|
| Rate for Payer: ASR ASR |
$52.14
|
| Rate for Payer: ASR Commercial |
$52.14
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Trust/PPO |
$44.02
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Whirlpool |
$52.14
|
| Rate for Payer: Mclaren Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.10
|
| Rate for Payer: Priority Health Narrow Network |
$37.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.30
|
|
|
SODIUM CHLORIDE 0.9 % IV - DKA
|
Facility
|
OP
|
$67.18
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
161519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.87 |
| Max. Negotiated Rate |
$67.18 |
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$33.59
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR ASR |
$67.82
|
| Rate for Payer: ASR Commercial |
$67.82
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: BCBS Complete |
$26.87
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCBS Trust/PPO |
$57.26
|
| Rate for Payer: BCN Commercial |
$54.21
|
| Rate for Payer: BCN Commercial |
$52.08
|
| Rate for Payer: Cash Price |
$53.75
|
| 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 |
$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 |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| 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: Priority Health HMO/PPO/Tiered Network |
$58.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.26
|
| Rate for Payer: Priority Health Narrow Network |
$49.01
|
| Rate for Payer: Priority Health Narrow Network |
$47.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
|
|
SODIUM CHLORIDE 0.9 % IV - DKA
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
161519
|
|
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 |
$65.16
|
| Rate for Payer: ASR ASR |
$67.82
|
| 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 |
$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 |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| 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 % IV - DKA
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
161519
|
|
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 % IV - DKA
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
161519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.40 |
| 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: 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 |
$49.06
|
| Rate for Payer: Priority Health Narrow Network |
$39.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.27
|
|
|
SODIUM CHLORIDE 0.9 % IV INFUSION (CODE)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
163715
|
|
Hospital Revenue Code
|
636
|
| 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 % IV INFUSION (CODE)
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
163715
|
|
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 % IV NON PVC BAG
|
Facility
|
IP
|
$67.18
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
150715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$67.18 |
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: ASR ASR |
$65.16
|
| Rate for Payer: ASR Commercial |
$65.16
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$52.08
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$63.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.74
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Healthscope Whirlpool |
$65.16
|
| Rate for Payer: Mclaren Commercial |
$60.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.10
|
| Rate for Payer: Nomi Health Commercial |
$55.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.12
|
|
