|
VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$355.70
|
|
|
Service Code
|
NDC 121067585
|
| Hospital Charge Code |
8428
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.61 |
| Max. Negotiated Rate |
$355.70 |
| Rate for Payer: Aetna Commercial |
$320.13
|
| Rate for Payer: Aetna Medicare |
$131.61
|
| Rate for Payer: ASR ASR |
$345.03
|
| Rate for Payer: BCBS Complete |
$142.28
|
| Rate for Payer: BCBS Trust/PPO |
$293.27
|
| Rate for Payer: BCN Commercial |
$293.27
|
| Rate for Payer: Cash Price |
$284.56
|
| Rate for Payer: Cofinity Commercial |
$334.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.56
|
| Rate for Payer: Healthscope Commercial |
$345.03
|
| Rate for Payer: Healthscope Whirlpool |
$355.70
|
| Rate for Payer: Mclaren Commercial |
$320.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.34
|
| Rate for Payer: Nomi Health Commercial |
$291.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$311.66
|
| Rate for Payer: Priority Health Narrow Network |
$249.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.01
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$516.96
|
|
|
Service Code
|
NDC 60687062301
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$387.72 |
| Max. Negotiated Rate |
$516.96 |
| Rate for Payer: Aetna Commercial |
$465.26
|
| Rate for Payer: ASR ASR |
$501.45
|
| Rate for Payer: BCBS Trust/PPO |
$424.53
|
| Rate for Payer: BCN Commercial |
$424.53
|
| Rate for Payer: Cash Price |
$413.57
|
| Rate for Payer: Cofinity Commercial |
$485.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.57
|
| Rate for Payer: Healthscope Commercial |
$501.45
|
| Rate for Payer: Healthscope Whirlpool |
$516.96
|
| Rate for Payer: Mclaren Commercial |
$465.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.42
|
| Rate for Payer: Nomi Health Commercial |
$423.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.92
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$5.17
|
|
|
Service Code
|
NDC 60687062311
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: ASR ASR |
$5.01
|
| Rate for Payer: BCBS Trust/PPO |
$4.25
|
| Rate for Payer: BCN Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$4.14
|
| Rate for Payer: Cofinity Commercial |
$4.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.14
|
| Rate for Payer: Healthscope Commercial |
$5.01
|
| Rate for Payer: Healthscope Whirlpool |
$5.17
|
| Rate for Payer: Mclaren Commercial |
$4.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.39
|
| Rate for Payer: Nomi Health Commercial |
$4.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.55
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$253.92
|
|
|
Service Code
|
NDC 50268074715
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$253.92 |
| Rate for Payer: Aetna Commercial |
$228.53
|
| Rate for Payer: ASR ASR |
$246.30
|
| Rate for Payer: BCBS Trust/PPO |
$208.52
|
| Rate for Payer: BCN Commercial |
$208.52
|
| Rate for Payer: Cash Price |
$203.14
|
| Rate for Payer: Cofinity Commercial |
$238.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.14
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Healthscope Whirlpool |
$253.92
|
| Rate for Payer: Mclaren Commercial |
$228.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.83
|
| Rate for Payer: Nomi Health Commercial |
$208.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.45
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$5.08
|
|
|
Service Code
|
NDC 50268074711
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$5.08 |
| Rate for Payer: Aetna Commercial |
$4.57
|
| Rate for Payer: ASR ASR |
$4.93
|
| Rate for Payer: BCBS Trust/PPO |
$4.17
|
| Rate for Payer: BCN Commercial |
$4.17
|
| Rate for Payer: Cash Price |
$4.06
|
| Rate for Payer: Cofinity Commercial |
$4.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.06
|
| Rate for Payer: Healthscope Commercial |
$4.93
|
| Rate for Payer: Healthscope Whirlpool |
$5.08
|
| Rate for Payer: Mclaren Commercial |
$4.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.32
|
| Rate for Payer: Nomi Health Commercial |
$4.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.47
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$3,022.31
|
|
|
Service Code
|
NDC 78035834
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,266.73 |
| Max. Negotiated Rate |
$3,022.31 |
| Rate for Payer: Aetna Commercial |
$2,720.08
|
| Rate for Payer: ASR ASR |
$2,931.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,481.92
|
| Rate for Payer: BCN Commercial |
$2,481.92
|
| Rate for Payer: Cash Price |
$2,417.85
|
| Rate for Payer: Cofinity Commercial |
$2,840.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.85
|
| Rate for Payer: Healthscope Commercial |
$2,931.64
|
| Rate for Payer: Healthscope Whirlpool |
$3,022.31
|
| Rate for Payer: Mclaren Commercial |
$2,720.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.96
|
| Rate for Payer: Nomi Health Commercial |
$2,478.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.63
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$5.08
|
|
|
Service Code
|
NDC 50268074711
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$5.08 |
| Rate for Payer: Aetna Commercial |
$4.57
|
| Rate for Payer: Aetna Medicare |
$1.88
|
| Rate for Payer: ASR ASR |
$4.93
|
| Rate for Payer: BCBS Complete |
$2.03
|
| Rate for Payer: BCBS Trust/PPO |
$4.19
|
| Rate for Payer: BCN Commercial |
$4.19
|
| Rate for Payer: Cash Price |
$4.06
|
| Rate for Payer: Cofinity Commercial |
$4.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.06
|
| Rate for Payer: Healthscope Commercial |
$4.93
|
| Rate for Payer: Healthscope Whirlpool |
$5.08
|
| Rate for Payer: Mclaren Commercial |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.32
|
| Rate for Payer: Nomi Health Commercial |
$4.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.45
|
| Rate for Payer: Priority Health Narrow Network |
$3.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.47
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$5.17
|
|
|
Service Code
|
NDC 60687062311
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: Aetna Medicare |
$1.91
|
| Rate for Payer: ASR ASR |
$5.01
|
| Rate for Payer: BCBS Complete |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$4.26
|
| Rate for Payer: BCN Commercial |
$4.26
|
| Rate for Payer: Cash Price |
$4.14
|
| Rate for Payer: Cofinity Commercial |
$4.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.14
|
| Rate for Payer: Healthscope Commercial |
$5.01
|
| Rate for Payer: Healthscope Whirlpool |
$5.17
|
| Rate for Payer: Mclaren Commercial |
$4.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.39
|
| Rate for Payer: Nomi Health Commercial |
$4.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.53
|
| Rate for Payer: Priority Health Narrow Network |
$3.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.55
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$410.31
|
|
|
Service Code
|
NDC 65862057190
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$151.81 |
| Max. Negotiated Rate |
$410.31 |
| Rate for Payer: Aetna Commercial |
$369.28
|
| Rate for Payer: Aetna Medicare |
$151.81
|
| Rate for Payer: ASR ASR |
$398.00
|
| Rate for Payer: BCBS Complete |
$164.12
|
| Rate for Payer: BCBS Trust/PPO |
$338.30
|
| Rate for Payer: BCN Commercial |
$338.30
|
| Rate for Payer: Cash Price |
$328.25
|
| Rate for Payer: Cofinity Commercial |
$385.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.25
|
| Rate for Payer: Healthscope Commercial |
$398.00
|
| Rate for Payer: Healthscope Whirlpool |
$410.31
|
| Rate for Payer: Mclaren Commercial |
$369.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.76
|
| Rate for Payer: Nomi Health Commercial |
$336.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$359.51
|
| Rate for Payer: Priority Health Narrow Network |
$287.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.07
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$253.92
|
|
|
Service Code
|
NDC 50268074715
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.95 |
| Max. Negotiated Rate |
$253.92 |
| Rate for Payer: Aetna Commercial |
$228.53
|
| Rate for Payer: Aetna Medicare |
$93.95
|
| Rate for Payer: ASR ASR |
$246.30
|
| Rate for Payer: BCBS Complete |
$101.57
|
| Rate for Payer: BCBS Trust/PPO |
$209.36
|
| Rate for Payer: BCN Commercial |
$209.36
|
| Rate for Payer: Cash Price |
$203.14
|
| Rate for Payer: Cofinity Commercial |
$238.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.14
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Healthscope Whirlpool |
$253.92
|
| Rate for Payer: Mclaren Commercial |
$228.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.83
|
| Rate for Payer: Nomi Health Commercial |
$208.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$222.48
|
| Rate for Payer: Priority Health Narrow Network |
$178.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.45
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$3,022.31
|
|
|
Service Code
|
NDC 78035834
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,118.25 |
| Max. Negotiated Rate |
$3,022.31 |
| Rate for Payer: Aetna Commercial |
$2,720.08
|
| Rate for Payer: Aetna Medicare |
$1,118.25
|
| Rate for Payer: ASR ASR |
$2,931.64
|
| Rate for Payer: BCBS Complete |
$1,208.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.89
|
| Rate for Payer: BCN Commercial |
$2,491.89
|
| Rate for Payer: Cash Price |
$2,417.85
|
| Rate for Payer: Cofinity Commercial |
$2,840.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.85
|
| Rate for Payer: Healthscope Commercial |
$2,931.64
|
| Rate for Payer: Healthscope Whirlpool |
$3,022.31
|
| Rate for Payer: Mclaren Commercial |
$2,720.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,417.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.96
|
| Rate for Payer: Nomi Health Commercial |
$2,478.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,648.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,118.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,659.63
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$129.02
|
|
|
Service Code
|
NDC 43547036809
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: BCBS Trust/PPO |
$105.95
|
| Rate for Payer: BCN Commercial |
$105.95
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$125.14
|
| Rate for Payer: Healthscope Whirlpool |
$129.01
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
IP
|
$410.31
|
|
|
Service Code
|
NDC 65862057190
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$307.73 |
| Max. Negotiated Rate |
$410.31 |
| Rate for Payer: Aetna Commercial |
$369.28
|
| Rate for Payer: ASR ASR |
$398.00
|
| Rate for Payer: BCBS Trust/PPO |
$336.95
|
| Rate for Payer: BCN Commercial |
$336.95
|
| Rate for Payer: Cash Price |
$328.25
|
| Rate for Payer: Cofinity Commercial |
$385.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.25
|
| Rate for Payer: Healthscope Commercial |
$398.00
|
| Rate for Payer: Healthscope Whirlpool |
$410.31
|
| Rate for Payer: Mclaren Commercial |
$369.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.76
|
| Rate for Payer: Nomi Health Commercial |
$336.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.07
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$129.02
|
|
|
Service Code
|
NDC 43547036809
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: Aetna Medicare |
$47.74
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: BCBS Complete |
$51.61
|
| Rate for Payer: BCBS Trust/PPO |
$106.37
|
| Rate for Payer: BCN Commercial |
$106.37
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$125.14
|
| Rate for Payer: Healthscope Whirlpool |
$129.01
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.04
|
| Rate for Payer: Priority Health Narrow Network |
$90.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
|
|
VALSARTAN 80 MG TABLET
|
Facility
|
OP
|
$516.96
|
|
|
Service Code
|
NDC 60687062301
|
| Hospital Charge Code |
31209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.28 |
| Max. Negotiated Rate |
$516.96 |
| Rate for Payer: Aetna Commercial |
$465.26
|
| Rate for Payer: Aetna Medicare |
$191.28
|
| Rate for Payer: ASR ASR |
$501.45
|
| Rate for Payer: BCBS Complete |
$206.78
|
| Rate for Payer: BCBS Trust/PPO |
$426.23
|
| Rate for Payer: BCN Commercial |
$426.23
|
| Rate for Payer: Cash Price |
$413.57
|
| Rate for Payer: Cofinity Commercial |
$485.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.57
|
| Rate for Payer: Healthscope Commercial |
$501.45
|
| Rate for Payer: Healthscope Whirlpool |
$516.96
|
| Rate for Payer: Mclaren Commercial |
$465.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.42
|
| Rate for Payer: Nomi Health Commercial |
$423.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$452.96
|
| Rate for Payer: Priority Health Narrow Network |
$362.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.92
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
OP
|
$23.06
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Aetna Medicare |
$8.53
|
| Rate for Payer: ASR ASR |
$22.36
|
| Rate for Payer: ASR ASR |
$16.42
|
| Rate for Payer: BCBS Complete |
$6.77
|
| Rate for Payer: BCBS Complete |
$9.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.01
|
| Rate for Payer: BCBS Trust/PPO |
$13.95
|
| Rate for Payer: BCN Commercial |
$13.95
|
| Rate for Payer: BCN Commercial |
$19.01
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$21.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.54
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Healthscope Whirlpool |
$23.05
|
| Rate for Payer: Healthscope Whirlpool |
$16.92
|
| Rate for Payer: Mclaren Commercial |
$20.75
|
| Rate for Payer: Mclaren Commercial |
$15.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Nomi Health Commercial |
$13.88
|
| Rate for Payer: Nomi Health Commercial |
$18.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.29
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
IP
|
$31.04
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: Aetna Commercial |
$59.74
|
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Commercial |
$18.58
|
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Commercial |
$17.36
|
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Commercial |
$24.84
|
| Rate for Payer: Aetna Commercial |
$22.35
|
| Rate for Payer: ASR ASR |
$24.09
|
| Rate for Payer: ASR ASR |
$21.52
|
| Rate for Payer: ASR ASR |
$18.33
|
| Rate for Payer: ASR ASR |
$14.83
|
| Rate for Payer: ASR ASR |
$20.02
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR ASR |
$18.71
|
| Rate for Payer: ASR ASR |
$64.39
|
| Rate for Payer: ASR ASR |
$30.11
|
| Rate for Payer: ASR ASR |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCBS Trust/PPO |
$20.39
|
| Rate for Payer: BCBS Trust/PPO |
$15.22
|
| Rate for Payer: BCBS Trust/PPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$18.22
|
| Rate for Payer: BCBS Trust/PPO |
$16.95
|
| Rate for Payer: BCBS Trust/PPO |
$22.67
|
| Rate for Payer: BCBS Trust/PPO |
$15.51
|
| Rate for Payer: BCBS Trust/PPO |
$15.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.56
|
| Rate for Payer: BCN Commercial |
$15.84
|
| Rate for Payer: BCN Commercial |
$15.51
|
| Rate for Payer: BCN Commercial |
$15.22
|
| Rate for Payer: BCN Commercial |
$16.95
|
| Rate for Payer: BCN Commercial |
$12.56
|
| Rate for Payer: BCN Commercial |
$18.22
|
| Rate for Payer: BCN Commercial |
$20.39
|
| Rate for Payer: BCN Commercial |
$22.67
|
| Rate for Payer: BCN Commercial |
$25.49
|
| Rate for Payer: BCN Commercial |
$54.51
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cash Price |
$22.08
|
| Rate for Payer: Cofinity Commercial |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Cofinity Commercial |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Cofinity Commercial |
$29.18
|
| Rate for Payer: Cofinity Commercial |
$23.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$21.52
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$30.11
|
| Rate for Payer: Healthscope Commercial |
$64.39
|
| Rate for Payer: Healthscope Commercial |
$18.33
|
| Rate for Payer: Healthscope Commercial |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$18.71
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Healthscope Whirlpool |
$15.29
|
| Rate for Payer: Healthscope Whirlpool |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$24.83
|
| Rate for Payer: Healthscope Whirlpool |
$18.89
|
| Rate for Payer: Healthscope Whirlpool |
$31.04
|
| Rate for Payer: Healthscope Whirlpool |
$66.38
|
| Rate for Payer: Healthscope Whirlpool |
$22.18
|
| Rate for Payer: Healthscope Whirlpool |
$27.60
|
| Rate for Payer: Healthscope Whirlpool |
$19.29
|
| Rate for Payer: Healthscope Whirlpool |
$20.64
|
| Rate for Payer: Mclaren Commercial |
$19.97
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Mclaren Commercial |
$17.36
|
| Rate for Payer: Mclaren Commercial |
$59.74
|
| Rate for Payer: Mclaren Commercial |
$22.35
|
| Rate for Payer: Mclaren Commercial |
$17.00
|
| Rate for Payer: Mclaren Commercial |
$13.76
|
| Rate for Payer: Mclaren Commercial |
$27.94
|
| Rate for Payer: Mclaren Commercial |
$18.58
|
| Rate for Payer: Mclaren Commercial |
$24.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$18.19
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: Nomi Health Commercial |
$12.54
|
| Rate for Payer: Nomi Health Commercial |
$54.43
|
| Rate for Payer: Nomi Health Commercial |
$15.81
|
| Rate for Payer: Nomi Health Commercial |
$15.49
|
| Rate for Payer: Nomi Health Commercial |
$22.63
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.42
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
IP
|
$16.92
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$16.92 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: ASR ASR |
$22.36
|
| Rate for Payer: ASR ASR |
$16.42
|
| Rate for Payer: BCBS Trust/PPO |
$18.93
|
| Rate for Payer: BCBS Trust/PPO |
$13.90
|
| Rate for Payer: BCN Commercial |
$18.93
|
| Rate for Payer: BCN Commercial |
$13.90
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$21.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.54
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Healthscope Whirlpool |
$23.05
|
| Rate for Payer: Healthscope Whirlpool |
$16.92
|
| Rate for Payer: Mclaren Commercial |
$20.75
|
| Rate for Payer: Mclaren Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.39
|
| Rate for Payer: Nomi Health Commercial |
$18.91
|
| Rate for Payer: Nomi Health Commercial |
$13.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.29
|
|
|
VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION
|
Facility
|
OP
|
$15.29
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8442
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$15.29 |
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$17.36
|
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Commercial |
$22.35
|
| Rate for Payer: Aetna Commercial |
$18.58
|
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Commercial |
$24.84
|
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: Aetna Commercial |
$59.74
|
| Rate for Payer: Aetna Commercial |
$16.69
|
| Rate for Payer: Aetna Medicare |
$8.21
|
| Rate for Payer: Aetna Medicare |
$9.19
|
| Rate for Payer: Aetna Medicare |
$6.99
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Aetna Medicare |
$6.86
|
| Rate for Payer: Aetna Medicare |
$24.56
|
| Rate for Payer: Aetna Medicare |
$11.48
|
| Rate for Payer: ASR ASR |
$20.02
|
| Rate for Payer: ASR ASR |
$18.71
|
| Rate for Payer: ASR ASR |
$17.98
|
| Rate for Payer: ASR ASR |
$14.83
|
| Rate for Payer: ASR ASR |
$18.33
|
| Rate for Payer: ASR ASR |
$64.39
|
| Rate for Payer: ASR ASR |
$30.11
|
| Rate for Payer: ASR ASR |
$26.77
|
| Rate for Payer: ASR ASR |
$24.09
|
| Rate for Payer: ASR ASR |
$21.52
|
| Rate for Payer: BCBS Complete |
$12.42
|
| Rate for Payer: BCBS Complete |
$11.04
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS Complete |
$9.93
|
| Rate for Payer: BCBS Complete |
$8.87
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Complete |
$26.55
|
| Rate for Payer: BCBS Complete |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$15.90
|
| Rate for Payer: BCBS Trust/PPO |
$15.29
|
| Rate for Payer: BCBS Trust/PPO |
$25.59
|
| Rate for Payer: BCBS Trust/PPO |
$12.61
|
| Rate for Payer: BCBS Trust/PPO |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$22.76
|
| Rate for Payer: BCBS Trust/PPO |
$20.47
|
| Rate for Payer: BCBS Trust/PPO |
$17.02
|
| Rate for Payer: BCBS Trust/PPO |
$18.29
|
| Rate for Payer: BCBS Trust/PPO |
$54.73
|
| Rate for Payer: BCN Commercial |
$22.76
|
| Rate for Payer: BCN Commercial |
$18.29
|
| Rate for Payer: BCN Commercial |
$15.58
|
| Rate for Payer: BCN Commercial |
$15.90
|
| Rate for Payer: BCN Commercial |
$25.59
|
| Rate for Payer: BCN Commercial |
$15.29
|
| Rate for Payer: BCN Commercial |
$12.61
|
| Rate for Payer: BCN Commercial |
$20.47
|
| Rate for Payer: BCN Commercial |
$54.73
|
| Rate for Payer: BCN Commercial |
$17.02
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cash Price |
$12.23
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Cash Price |
$22.08
|
| Rate for Payer: Cash Price |
$22.08
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cofinity Commercial |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$29.18
|
| Rate for Payer: Cofinity Commercial |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$23.34
|
| Rate for Payer: Cofinity Commercial |
$14.37
|
| Rate for Payer: Cofinity Commercial |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Cofinity Commercial |
$17.43
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$18.71
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$30.11
|
| Rate for Payer: Healthscope Commercial |
$18.33
|
| Rate for Payer: Healthscope Commercial |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$21.52
|
| Rate for Payer: Healthscope Commercial |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$64.39
|
| Rate for Payer: Healthscope Whirlpool |
$18.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.18
|
| Rate for Payer: Healthscope Whirlpool |
$19.29
|
| Rate for Payer: Healthscope Whirlpool |
$27.60
|
| Rate for Payer: Healthscope Whirlpool |
$24.83
|
| Rate for Payer: Healthscope Whirlpool |
$66.38
|
| Rate for Payer: Healthscope Whirlpool |
$20.64
|
| Rate for Payer: Healthscope Whirlpool |
$18.54
|
| Rate for Payer: Healthscope Whirlpool |
$15.29
|
| Rate for Payer: Healthscope Whirlpool |
$31.04
|
| Rate for Payer: Mclaren Commercial |
$13.76
|
| Rate for Payer: Mclaren Commercial |
$27.94
|
| Rate for Payer: Mclaren Commercial |
$22.35
|
| Rate for Payer: Mclaren Commercial |
$18.58
|
| Rate for Payer: Mclaren Commercial |
$19.97
|
| Rate for Payer: Mclaren Commercial |
$59.74
|
| Rate for Payer: Mclaren Commercial |
$17.36
|
| Rate for Payer: Mclaren Commercial |
$24.84
|
| Rate for Payer: Mclaren Commercial |
$16.69
|
| Rate for Payer: Mclaren Commercial |
$17.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Nomi Health Commercial |
$22.63
|
| Rate for Payer: Nomi Health Commercial |
$54.43
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: Nomi Health Commercial |
$18.19
|
| Rate for Payer: Nomi Health Commercial |
$12.54
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$15.49
|
| Rate for Payer: Nomi Health Commercial |
$15.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.85
|
|
|
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$123.84
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
11627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$123.84 |
| Rate for Payer: Aetna Commercial |
$111.46
|
| Rate for Payer: Aetna Medicare |
$45.82
|
| Rate for Payer: ASR ASR |
$120.13
|
| Rate for Payer: BCBS Complete |
$49.54
|
| Rate for Payer: BCBS Trust/PPO |
$102.11
|
| Rate for Payer: BCN Commercial |
$102.11
|
| Rate for Payer: Cash Price |
$99.08
|
| Rate for Payer: Cash Price |
$99.08
|
| Rate for Payer: Cofinity Commercial |
$116.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.08
|
| Rate for Payer: Healthscope Commercial |
$120.13
|
| Rate for Payer: Healthscope Whirlpool |
$123.84
|
| Rate for Payer: Mclaren Commercial |
$111.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.27
|
| Rate for Payer: Nomi Health Commercial |
$101.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.98
|
|
|
VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$123.84
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
11627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$92.88 |
| Max. Negotiated Rate |
$123.84 |
| Rate for Payer: Aetna Commercial |
$111.46
|
| Rate for Payer: ASR ASR |
$120.13
|
| Rate for Payer: BCBS Trust/PPO |
$101.70
|
| Rate for Payer: BCN Commercial |
$101.70
|
| Rate for Payer: Cash Price |
$99.08
|
| Rate for Payer: Cofinity Commercial |
$116.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.08
|
| Rate for Payer: Healthscope Commercial |
$120.13
|
| Rate for Payer: Healthscope Whirlpool |
$123.84
|
| Rate for Payer: Mclaren Commercial |
$111.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.27
|
| Rate for Payer: Nomi Health Commercial |
$101.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.98
|
|
|
VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$43.13
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189454
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$43.13 |
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: Aetna Commercial |
$34.73
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna Medicare |
$15.96
|
| Rate for Payer: ASR ASR |
$41.84
|
| Rate for Payer: ASR ASR |
$37.43
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS Complete |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.56
|
| Rate for Payer: BCBS Trust/PPO |
$31.82
|
| Rate for Payer: BCN Commercial |
$31.82
|
| Rate for Payer: BCN Commercial |
$35.56
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$30.87
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$30.87
|
| Rate for Payer: Cofinity Commercial |
$36.28
|
| Rate for Payer: Cofinity Commercial |
$40.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.87
|
| Rate for Payer: Healthscope Commercial |
$41.84
|
| Rate for Payer: Healthscope Commercial |
$37.43
|
| Rate for Payer: Healthscope Whirlpool |
$43.13
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Mclaren Commercial |
$38.82
|
| Rate for Payer: Mclaren Commercial |
$34.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Nomi Health Commercial |
$31.64
|
| Rate for Payer: Nomi Health Commercial |
$35.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.95
|
|
|
VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$38.59
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189454
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.94 |
| Max. Negotiated Rate |
$38.59 |
| Rate for Payer: Aetna Commercial |
$34.73
|
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: ASR ASR |
$41.84
|
| Rate for Payer: ASR ASR |
$37.43
|
| Rate for Payer: BCBS Trust/PPO |
$35.42
|
| Rate for Payer: BCBS Trust/PPO |
$31.69
|
| Rate for Payer: BCN Commercial |
$35.42
|
| Rate for Payer: BCN Commercial |
$31.69
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cash Price |
$30.87
|
| Rate for Payer: Cofinity Commercial |
$36.28
|
| Rate for Payer: Cofinity Commercial |
$40.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.87
|
| Rate for Payer: Healthscope Commercial |
$37.43
|
| Rate for Payer: Healthscope Commercial |
$41.84
|
| Rate for Payer: Healthscope Whirlpool |
$43.13
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Mclaren Commercial |
$38.82
|
| Rate for Payer: Mclaren Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.80
|
| Rate for Payer: Nomi Health Commercial |
$35.37
|
| Rate for Payer: Nomi Health Commercial |
$31.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.95
|
|
|
VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$52.15
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
189183
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.11 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$46.93
|
| Rate for Payer: ASR ASR |
$50.58
|
| Rate for Payer: BCBS Trust/PPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$41.72
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.72
|
| Rate for Payer: Healthscope Commercial |
$50.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.15
|
| Rate for Payer: Mclaren Commercial |
$46.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.32
|
| Rate for Payer: Nomi Health Commercial |
$42.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.89
|
|
|
VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$52.15
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
189183
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$52.15 |
| Rate for Payer: Aetna Commercial |
$46.93
|
| Rate for Payer: Aetna Medicare |
$19.29
|
| Rate for Payer: ASR ASR |
$50.58
|
| Rate for Payer: BCBS Complete |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$42.99
|
| Rate for Payer: BCN Commercial |
$42.99
|
| Rate for Payer: Cash Price |
$41.72
|
| Rate for Payer: Cash Price |
$41.72
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.72
|
| Rate for Payer: Healthscope Commercial |
$50.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.15
|
| Rate for Payer: Mclaren Commercial |
$46.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.32
|
| Rate for Payer: Nomi Health Commercial |
$42.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.03
|
| Rate for Payer: Priority Health Narrow Network |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.89
|
|
