|
VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$49.66
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189183
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$44.70
|
| Rate for Payer: Aetna Commercial |
$37.25
|
| Rate for Payer: Aetna Medicare |
$15.31
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: ASR ASR |
$48.17
|
| Rate for Payer: ASR ASR |
$40.14
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS Complete |
$19.86
|
| Rate for Payer: BCBS Trust/PPO |
$40.95
|
| Rate for Payer: BCBS Trust/PPO |
$34.12
|
| Rate for Payer: BCN Commercial |
$34.12
|
| Rate for Payer: BCN Commercial |
$40.95
|
| Rate for Payer: Cash Price |
$39.73
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cash Price |
$39.73
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Cofinity Commercial |
$46.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Healthscope Commercial |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$40.14
|
| Rate for Payer: Healthscope Whirlpool |
$49.66
|
| Rate for Payer: Healthscope Whirlpool |
$41.38
|
| Rate for Payer: Mclaren Commercial |
$44.70
|
| Rate for Payer: Mclaren Commercial |
$37.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.21
|
| Rate for Payer: Nomi Health Commercial |
$33.94
|
| Rate for Payer: Nomi Health Commercial |
$40.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.25
|
| 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 |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.70
|
|
|
VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$41.39
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
189183
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$41.38 |
| Rate for Payer: Aetna Commercial |
$37.25
|
| Rate for Payer: Aetna Commercial |
$44.70
|
| Rate for Payer: ASR ASR |
$48.17
|
| Rate for Payer: ASR ASR |
$40.14
|
| Rate for Payer: BCBS Trust/PPO |
$40.78
|
| Rate for Payer: BCBS Trust/PPO |
$33.99
|
| Rate for Payer: BCN Commercial |
$40.78
|
| Rate for Payer: BCN Commercial |
$33.99
|
| Rate for Payer: Cash Price |
$39.73
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Cofinity Commercial |
$46.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Healthscope Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$48.17
|
| Rate for Payer: Healthscope Whirlpool |
$49.66
|
| Rate for Payer: Healthscope Whirlpool |
$41.38
|
| Rate for Payer: Mclaren Commercial |
$44.70
|
| Rate for Payer: Mclaren Commercial |
$37.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: Nomi Health Commercial |
$40.72
|
| Rate for Payer: Nomi Health Commercial |
$33.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.70
|
|
|
VANCOMYCIN 1.75 GRAM/350 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$98.12
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
194743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$98.12 |
| Rate for Payer: Aetna Commercial |
$88.31
|
| Rate for Payer: Aetna Medicare |
$36.31
|
| Rate for Payer: ASR ASR |
$95.18
|
| Rate for Payer: BCBS Complete |
$39.25
|
| Rate for Payer: BCBS Trust/PPO |
$80.90
|
| Rate for Payer: BCN Commercial |
$80.90
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cofinity Commercial |
$92.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.50
|
| Rate for Payer: Healthscope Commercial |
$95.18
|
| Rate for Payer: Healthscope Whirlpool |
$98.12
|
| Rate for Payer: Mclaren Commercial |
$88.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.40
|
| Rate for Payer: Nomi Health Commercial |
$80.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.35
|
|
|
VANCOMYCIN 1.75 GRAM/350 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$98.12
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
194743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.59 |
| Max. Negotiated Rate |
$98.12 |
| Rate for Payer: Aetna Commercial |
$88.31
|
| Rate for Payer: ASR ASR |
$95.18
|
| Rate for Payer: BCBS Trust/PPO |
$80.58
|
| Rate for Payer: BCN Commercial |
$80.58
|
| Rate for Payer: Cash Price |
$78.50
|
| Rate for Payer: Cofinity Commercial |
$92.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.50
|
| Rate for Payer: Healthscope Commercial |
$95.18
|
| Rate for Payer: Healthscope Whirlpool |
$98.12
|
| Rate for Payer: Mclaren Commercial |
$88.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.40
|
| Rate for Payer: Nomi Health Commercial |
$80.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.35
|
|
|
VANCOMYCIN 1 GRAM/200 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$56.07
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
189876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$56.07 |
| Rate for Payer: Aetna Commercial |
$50.46
|
| Rate for Payer: Aetna Medicare |
$20.75
|
| Rate for Payer: ASR ASR |
$54.39
|
| Rate for Payer: BCBS Complete |
$22.43
|
| Rate for Payer: BCBS Trust/PPO |
$46.23
|
| Rate for Payer: BCN Commercial |
$46.23
|
| Rate for Payer: Cash Price |
$44.86
|
| Rate for Payer: Cash Price |
$44.86
|
| Rate for Payer: Cofinity Commercial |
$52.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.86
|
| Rate for Payer: Healthscope Commercial |
$54.39
|
| Rate for Payer: Healthscope Whirlpool |
$56.07
|
| Rate for Payer: Mclaren Commercial |
$50.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.66
|
| Rate for Payer: Nomi Health Commercial |
$45.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.34
|
|
|
VANCOMYCIN 1 GRAM/200 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$56.07
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
189876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.05 |
| Max. Negotiated Rate |
$56.07 |
| Rate for Payer: Aetna Commercial |
$50.46
|
| Rate for Payer: ASR ASR |
$54.39
|
| Rate for Payer: BCBS Trust/PPO |
$46.04
|
| Rate for Payer: BCN Commercial |
$46.04
|
| Rate for Payer: Cash Price |
$44.86
|
| Rate for Payer: Cofinity Commercial |
$52.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.86
|
| Rate for Payer: Healthscope Commercial |
$54.39
|
| Rate for Payer: Healthscope Whirlpool |
$56.07
|
| Rate for Payer: Mclaren Commercial |
$50.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.66
|
| Rate for Payer: Nomi Health Commercial |
$45.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.34
|
|
|
VANCOMYCIN 25 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$690.30
|
|
|
Service Code
|
NDC 65628020405
|
| Hospital Charge Code |
186107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$255.41 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna Commercial |
$621.27
|
| Rate for Payer: Aetna Medicare |
$255.41
|
| Rate for Payer: ASR ASR |
$669.59
|
| Rate for Payer: BCBS Complete |
$276.12
|
| Rate for Payer: BCBS Trust/PPO |
$569.15
|
| Rate for Payer: BCN Commercial |
$569.15
|
| Rate for Payer: Cash Price |
$552.24
|
| Rate for Payer: Cofinity Commercial |
$648.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.24
|
| Rate for Payer: Healthscope Commercial |
$669.59
|
| Rate for Payer: Healthscope Whirlpool |
$690.30
|
| Rate for Payer: Mclaren Commercial |
$621.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.75
|
| Rate for Payer: Nomi Health Commercial |
$566.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$604.84
|
| Rate for Payer: Priority Health Narrow Network |
$483.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.46
|
|
|
VANCOMYCIN 25 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$690.30
|
|
|
Service Code
|
NDC 65628020405
|
| Hospital Charge Code |
186107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$517.73 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna Commercial |
$621.27
|
| Rate for Payer: ASR ASR |
$669.59
|
| Rate for Payer: BCBS Trust/PPO |
$566.87
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: Cash Price |
$552.24
|
| Rate for Payer: Cofinity Commercial |
$648.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.24
|
| Rate for Payer: Healthscope Commercial |
$669.59
|
| Rate for Payer: Healthscope Whirlpool |
$690.30
|
| Rate for Payer: Mclaren Commercial |
$621.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.75
|
| Rate for Payer: Nomi Health Commercial |
$566.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.46
|
|
|
VANCOMYCIN 2 GRAM/400 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$112.14
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
190617
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$112.14 |
| Rate for Payer: Aetna Commercial |
$100.93
|
| Rate for Payer: Aetna Medicare |
$41.49
|
| Rate for Payer: ASR ASR |
$108.78
|
| Rate for Payer: BCBS Complete |
$44.86
|
| Rate for Payer: BCBS Trust/PPO |
$92.46
|
| Rate for Payer: BCN Commercial |
$92.46
|
| Rate for Payer: Cash Price |
$89.71
|
| Rate for Payer: Cash Price |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$105.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.71
|
| Rate for Payer: Healthscope Commercial |
$108.78
|
| Rate for Payer: Healthscope Whirlpool |
$112.14
|
| Rate for Payer: Mclaren Commercial |
$100.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.32
|
| Rate for Payer: Nomi Health Commercial |
$91.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.68
|
|
|
VANCOMYCIN 2 GRAM/400 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$112.14
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
190617
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.11 |
| Max. Negotiated Rate |
$112.14 |
| Rate for Payer: Aetna Commercial |
$100.93
|
| Rate for Payer: ASR ASR |
$108.78
|
| Rate for Payer: BCBS Trust/PPO |
$92.09
|
| Rate for Payer: BCN Commercial |
$92.09
|
| Rate for Payer: Cash Price |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$105.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.71
|
| Rate for Payer: Healthscope Commercial |
$108.78
|
| Rate for Payer: Healthscope Whirlpool |
$112.14
|
| Rate for Payer: Mclaren Commercial |
$100.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.32
|
| Rate for Payer: Nomi Health Commercial |
$91.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.68
|
|
|
VANCOMYCIN 500 MG/100 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$28.04
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
191707
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: ASR ASR |
$27.19
|
| Rate for Payer: BCBS Trust/PPO |
$23.02
|
| Rate for Payer: BCN Commercial |
$23.02
|
| Rate for Payer: Cash Price |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$26.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$27.19
|
| Rate for Payer: Healthscope Whirlpool |
$28.04
|
| Rate for Payer: Mclaren Commercial |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.83
|
| Rate for Payer: Nomi Health Commercial |
$22.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.67
|
|
|
VANCOMYCIN 500 MG/100 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$28.04
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
191707
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: Aetna Medicare |
$10.37
|
| Rate for Payer: ASR ASR |
$27.19
|
| Rate for Payer: BCBS Complete |
$11.21
|
| Rate for Payer: BCBS Trust/PPO |
$23.11
|
| Rate for Payer: BCN Commercial |
$23.11
|
| Rate for Payer: Cash Price |
$22.43
|
| Rate for Payer: Cash Price |
$22.43
|
| Rate for Payer: Cofinity Commercial |
$26.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$27.19
|
| Rate for Payer: Healthscope Whirlpool |
$28.04
|
| Rate for Payer: Mclaren Commercial |
$25.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.83
|
| Rate for Payer: Nomi Health Commercial |
$22.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.67
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.20
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$23.20 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Commercial |
$24.61
|
| Rate for Payer: Aetna Commercial |
$10.92
|
| Rate for Payer: Aetna Commercial |
$14.56
|
| Rate for Payer: Aetna Commercial |
$29.95
|
| Rate for Payer: Aetna Commercial |
$24.64
|
| Rate for Payer: Aetna Commercial |
$15.05
|
| Rate for Payer: Aetna Commercial |
$16.82
|
| Rate for Payer: Aetna Medicare |
$6.92
|
| Rate for Payer: Aetna Medicare |
$8.58
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Aetna Medicare |
$10.12
|
| Rate for Payer: Aetna Medicare |
$10.13
|
| Rate for Payer: Aetna Medicare |
$12.31
|
| Rate for Payer: Aetna Medicare |
$6.19
|
| Rate for Payer: Aetna Medicare |
$4.49
|
| Rate for Payer: ASR ASR |
$22.50
|
| Rate for Payer: ASR ASR |
$18.13
|
| Rate for Payer: ASR ASR |
$15.69
|
| Rate for Payer: ASR ASR |
$11.77
|
| Rate for Payer: ASR ASR |
$16.22
|
| Rate for Payer: ASR ASR |
$32.27
|
| Rate for Payer: ASR ASR |
$26.55
|
| Rate for Payer: ASR ASR |
$26.53
|
| Rate for Payer: BCBS Complete |
$6.69
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS Complete |
$10.95
|
| Rate for Payer: BCBS Complete |
$13.31
|
| Rate for Payer: BCBS Complete |
$6.47
|
| Rate for Payer: BCBS Complete |
$10.94
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Trust/PPO |
$13.34
|
| Rate for Payer: BCBS Trust/PPO |
$10.01
|
| Rate for Payer: BCBS Trust/PPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$27.43
|
| Rate for Payer: BCBS Trust/PPO |
$22.57
|
| Rate for Payer: BCBS Trust/PPO |
$19.13
|
| Rate for Payer: BCBS Trust/PPO |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$15.41
|
| Rate for Payer: BCN Commercial |
$10.01
|
| Rate for Payer: BCN Commercial |
$19.13
|
| Rate for Payer: BCN Commercial |
$27.43
|
| Rate for Payer: BCN Commercial |
$13.79
|
| Rate for Payer: BCN Commercial |
$15.41
|
| Rate for Payer: BCN Commercial |
$13.34
|
| Rate for Payer: BCN Commercial |
$22.57
|
| Rate for Payer: BCN Commercial |
$22.55
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$15.72
|
| Rate for Payer: Cofinity Commercial |
$17.57
|
| Rate for Payer: Cofinity Commercial |
$25.71
|
| Rate for Payer: Cofinity Commercial |
$31.28
|
| Rate for Payer: Cofinity Commercial |
$25.73
|
| Rate for Payer: Cofinity Commercial |
$21.81
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Healthscope Commercial |
$18.13
|
| Rate for Payer: Healthscope Commercial |
$32.27
|
| Rate for Payer: Healthscope Commercial |
$26.55
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Healthscope Commercial |
$15.69
|
| Rate for Payer: Healthscope Commercial |
$11.77
|
| Rate for Payer: Healthscope Commercial |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Healthscope Whirlpool |
$12.14
|
| Rate for Payer: Healthscope Whirlpool |
$33.27
|
| Rate for Payer: Healthscope Whirlpool |
$18.69
|
| Rate for Payer: Healthscope Whirlpool |
$23.20
|
| Rate for Payer: Healthscope Whirlpool |
$27.35
|
| Rate for Payer: Healthscope Whirlpool |
$16.18
|
| Rate for Payer: Healthscope Whirlpool |
$27.38
|
| Rate for Payer: Healthscope Whirlpool |
$16.72
|
| Rate for Payer: Mclaren Commercial |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$16.82
|
| Rate for Payer: Mclaren Commercial |
$24.61
|
| Rate for Payer: Mclaren Commercial |
$24.64
|
| Rate for Payer: Mclaren Commercial |
$10.92
|
| Rate for Payer: Mclaren Commercial |
$14.56
|
| Rate for Payer: Mclaren Commercial |
$20.88
|
| Rate for Payer: Mclaren Commercial |
$29.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.32
|
| Rate for Payer: Nomi Health Commercial |
$9.95
|
| Rate for Payer: Nomi Health Commercial |
$27.28
|
| Rate for Payer: Nomi Health Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$15.33
|
| Rate for Payer: Nomi Health Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$22.42
|
| Rate for Payer: Nomi Health Commercial |
$22.45
|
| Rate for Payer: Nomi Health Commercial |
$19.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.10
|
| 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: UHC All Payor (Choice/PPO) + Core |
$10.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.07
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.42
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$19.42 |
| Rate for Payer: Aetna Commercial |
$17.47
|
| Rate for Payer: ASR ASR |
$18.83
|
| Rate for Payer: BCBS Trust/PPO |
$15.94
|
| Rate for Payer: BCN Commercial |
$15.94
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.53
|
| Rate for Payer: Healthscope Commercial |
$18.83
|
| Rate for Payer: Healthscope Whirlpool |
$19.42
|
| Rate for Payer: Mclaren Commercial |
$17.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.50
|
| Rate for Payer: Nomi Health Commercial |
$15.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.09
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.42
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$19.42 |
| Rate for Payer: Aetna Commercial |
$17.47
|
| Rate for Payer: Aetna Medicare |
$7.18
|
| Rate for Payer: ASR ASR |
$18.83
|
| Rate for Payer: BCBS Complete |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$16.01
|
| Rate for Payer: BCN Commercial |
$16.01
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.53
|
| Rate for Payer: Healthscope Commercial |
$18.83
|
| Rate for Payer: Healthscope Whirlpool |
$19.42
|
| Rate for Payer: Mclaren Commercial |
$17.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.50
|
| Rate for Payer: Nomi Health Commercial |
$15.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.56
|
| 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: UHC All Payor (Choice/PPO) + Core |
$17.09
|
|
|
VANCOMYCIN 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.38
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$27.38 |
| Rate for Payer: Aetna Commercial |
$24.64
|
| Rate for Payer: Aetna Commercial |
$29.95
|
| Rate for Payer: Aetna Commercial |
$16.82
|
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Commercial |
$14.56
|
| Rate for Payer: Aetna Commercial |
$10.92
|
| Rate for Payer: Aetna Commercial |
$24.61
|
| Rate for Payer: Aetna Commercial |
$15.05
|
| Rate for Payer: ASR ASR |
$16.22
|
| Rate for Payer: ASR ASR |
$26.55
|
| Rate for Payer: ASR ASR |
$22.50
|
| Rate for Payer: ASR ASR |
$32.27
|
| Rate for Payer: ASR ASR |
$15.69
|
| Rate for Payer: ASR ASR |
$18.13
|
| Rate for Payer: ASR ASR |
$11.77
|
| Rate for Payer: ASR ASR |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$9.97
|
| Rate for Payer: BCBS Trust/PPO |
$13.28
|
| Rate for Payer: BCBS Trust/PPO |
$19.05
|
| Rate for Payer: BCBS Trust/PPO |
$27.32
|
| Rate for Payer: BCBS Trust/PPO |
$22.48
|
| Rate for Payer: BCBS Trust/PPO |
$22.46
|
| Rate for Payer: BCBS Trust/PPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$15.35
|
| Rate for Payer: BCN Commercial |
$13.28
|
| Rate for Payer: BCN Commercial |
$13.73
|
| Rate for Payer: BCN Commercial |
$27.32
|
| Rate for Payer: BCN Commercial |
$15.35
|
| Rate for Payer: BCN Commercial |
$19.05
|
| Rate for Payer: BCN Commercial |
$9.97
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: BCN Commercial |
$22.48
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cash Price |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$25.71
|
| Rate for Payer: Cofinity Commercial |
$15.72
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Cofinity Commercial |
$17.57
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$31.28
|
| Rate for Payer: Cofinity Commercial |
$21.81
|
| Rate for Payer: Cofinity Commercial |
$25.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$15.69
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Healthscope Commercial |
$32.27
|
| Rate for Payer: Healthscope Commercial |
$26.55
|
| Rate for Payer: Healthscope Commercial |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$11.77
|
| Rate for Payer: Healthscope Commercial |
$18.13
|
| Rate for Payer: Healthscope Whirlpool |
$16.72
|
| Rate for Payer: Healthscope Whirlpool |
$18.69
|
| Rate for Payer: Healthscope Whirlpool |
$16.18
|
| Rate for Payer: Healthscope Whirlpool |
$23.20
|
| Rate for Payer: Healthscope Whirlpool |
$12.14
|
| Rate for Payer: Healthscope Whirlpool |
$27.35
|
| Rate for Payer: Healthscope Whirlpool |
$27.38
|
| Rate for Payer: Healthscope Whirlpool |
$33.27
|
| Rate for Payer: Mclaren Commercial |
$20.88
|
| Rate for Payer: Mclaren Commercial |
$29.95
|
| Rate for Payer: Mclaren Commercial |
$10.92
|
| Rate for Payer: Mclaren Commercial |
$14.56
|
| Rate for Payer: Mclaren Commercial |
$16.82
|
| Rate for Payer: Mclaren Commercial |
$24.64
|
| Rate for Payer: Mclaren Commercial |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$24.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: Nomi Health Commercial |
$19.02
|
| Rate for Payer: Nomi Health Commercial |
$27.28
|
| Rate for Payer: Nomi Health Commercial |
$22.42
|
| Rate for Payer: Nomi Health Commercial |
$9.95
|
| Rate for Payer: Nomi Health Commercial |
$15.33
|
| Rate for Payer: Nomi Health Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$22.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.07
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$731.52
|
|
|
Service Code
|
NDC 65628020605
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$548.64 |
| Max. Negotiated Rate |
$731.52 |
| Rate for Payer: Aetna Commercial |
$658.37
|
| Rate for Payer: ASR ASR |
$709.57
|
| Rate for Payer: BCBS Trust/PPO |
$600.72
|
| Rate for Payer: BCN Commercial |
$600.72
|
| Rate for Payer: Cash Price |
$585.22
|
| Rate for Payer: Cofinity Commercial |
$687.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$585.22
|
| Rate for Payer: Healthscope Commercial |
$709.57
|
| Rate for Payer: Healthscope Whirlpool |
$731.52
|
| Rate for Payer: Mclaren Commercial |
$658.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$621.79
|
| Rate for Payer: Nomi Health Commercial |
$599.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$548.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$643.74
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$731.52
|
|
|
Service Code
|
NDC 65628020605
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$270.66 |
| Max. Negotiated Rate |
$731.52 |
| Rate for Payer: Aetna Commercial |
$658.37
|
| Rate for Payer: Aetna Medicare |
$270.66
|
| Rate for Payer: ASR ASR |
$709.57
|
| Rate for Payer: BCBS Complete |
$292.61
|
| Rate for Payer: BCBS Trust/PPO |
$603.14
|
| Rate for Payer: BCN Commercial |
$603.14
|
| Rate for Payer: Cash Price |
$585.22
|
| Rate for Payer: Cofinity Commercial |
$687.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$585.22
|
| Rate for Payer: Healthscope Commercial |
$709.57
|
| Rate for Payer: Healthscope Whirlpool |
$731.52
|
| Rate for Payer: Mclaren Commercial |
$658.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$585.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$621.79
|
| Rate for Payer: Nomi Health Commercial |
$599.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$548.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$640.96
|
| Rate for Payer: Priority Health Narrow Network |
$512.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$643.74
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$779.04
|
|
|
Service Code
|
NDC 52536010605
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$584.28 |
| Max. Negotiated Rate |
$779.04 |
| Rate for Payer: Aetna Commercial |
$701.14
|
| Rate for Payer: ASR ASR |
$755.67
|
| Rate for Payer: BCBS Trust/PPO |
$639.75
|
| Rate for Payer: BCN Commercial |
$639.75
|
| Rate for Payer: Cash Price |
$623.23
|
| Rate for Payer: Cofinity Commercial |
$732.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$755.67
|
| Rate for Payer: Healthscope Whirlpool |
$779.04
|
| Rate for Payer: Mclaren Commercial |
$701.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$662.18
|
| Rate for Payer: Nomi Health Commercial |
$638.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$584.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$685.56
|
|
|
VANCOMYCIN 50 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$779.04
|
|
|
Service Code
|
NDC 52536010605
|
| Hospital Charge Code |
11630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$288.24 |
| Max. Negotiated Rate |
$779.04 |
| Rate for Payer: Aetna Commercial |
$701.14
|
| Rate for Payer: Aetna Medicare |
$288.24
|
| Rate for Payer: ASR ASR |
$755.67
|
| Rate for Payer: BCBS Complete |
$311.62
|
| Rate for Payer: BCBS Trust/PPO |
$642.32
|
| Rate for Payer: BCN Commercial |
$642.32
|
| Rate for Payer: Cash Price |
$623.23
|
| Rate for Payer: Cofinity Commercial |
$732.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$755.67
|
| Rate for Payer: Healthscope Whirlpool |
$779.04
|
| Rate for Payer: Mclaren Commercial |
$701.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$623.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$662.18
|
| Rate for Payer: Nomi Health Commercial |
$638.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$584.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$682.59
|
| Rate for Payer: Priority Health Narrow Network |
$546.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$685.56
|
|
|
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$68.04
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$68.04 |
| Rate for Payer: Aetna Commercial |
$61.24
|
| Rate for Payer: Aetna Commercial |
$73.37
|
| Rate for Payer: Aetna Commercial |
$264.23
|
| Rate for Payer: Aetna Commercial |
$236.24
|
| Rate for Payer: Aetna Commercial |
$65.20
|
| Rate for Payer: Aetna Medicare |
$30.16
|
| Rate for Payer: Aetna Medicare |
$97.12
|
| Rate for Payer: Aetna Medicare |
$26.81
|
| Rate for Payer: Aetna Medicare |
$25.18
|
| Rate for Payer: Aetna Medicare |
$108.63
|
| Rate for Payer: ASR ASR |
$66.00
|
| Rate for Payer: ASR ASR |
$79.08
|
| Rate for Payer: ASR ASR |
$70.27
|
| Rate for Payer: ASR ASR |
$284.78
|
| Rate for Payer: ASR ASR |
$254.61
|
| Rate for Payer: BCBS Complete |
$28.98
|
| Rate for Payer: BCBS Complete |
$104.99
|
| Rate for Payer: BCBS Complete |
$32.61
|
| Rate for Payer: BCBS Complete |
$27.22
|
| Rate for Payer: BCBS Complete |
$117.43
|
| Rate for Payer: BCBS Trust/PPO |
$216.42
|
| Rate for Payer: BCBS Trust/PPO |
$242.06
|
| Rate for Payer: BCBS Trust/PPO |
$59.73
|
| Rate for Payer: BCBS Trust/PPO |
$67.22
|
| Rate for Payer: BCBS Trust/PPO |
$56.10
|
| Rate for Payer: BCN Commercial |
$59.73
|
| Rate for Payer: BCN Commercial |
$242.06
|
| Rate for Payer: BCN Commercial |
$216.42
|
| Rate for Payer: BCN Commercial |
$67.22
|
| Rate for Payer: BCN Commercial |
$56.10
|
| Rate for Payer: Cash Price |
$57.96
|
| Rate for Payer: Cash Price |
$54.43
|
| Rate for Payer: Cash Price |
$209.99
|
| Rate for Payer: Cash Price |
$234.87
|
| Rate for Payer: Cash Price |
$234.87
|
| Rate for Payer: Cash Price |
$209.99
|
| Rate for Payer: Cash Price |
$54.43
|
| Rate for Payer: Cash Price |
$57.96
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cofinity Commercial |
$246.74
|
| Rate for Payer: Cofinity Commercial |
$76.63
|
| Rate for Payer: Cofinity Commercial |
$275.97
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.87
|
| Rate for Payer: Healthscope Commercial |
$254.61
|
| Rate for Payer: Healthscope Commercial |
$284.78
|
| Rate for Payer: Healthscope Commercial |
$79.08
|
| Rate for Payer: Healthscope Commercial |
$66.00
|
| Rate for Payer: Healthscope Commercial |
$70.27
|
| Rate for Payer: Healthscope Whirlpool |
$68.04
|
| Rate for Payer: Healthscope Whirlpool |
$262.49
|
| Rate for Payer: Healthscope Whirlpool |
$293.58
|
| Rate for Payer: Healthscope Whirlpool |
$81.52
|
| Rate for Payer: Healthscope Whirlpool |
$72.45
|
| Rate for Payer: Mclaren Commercial |
$264.23
|
| Rate for Payer: Mclaren Commercial |
$236.24
|
| Rate for Payer: Mclaren Commercial |
$73.37
|
| Rate for Payer: Mclaren Commercial |
$65.20
|
| Rate for Payer: Mclaren Commercial |
$61.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.83
|
| Rate for Payer: Nomi Health Commercial |
$240.74
|
| Rate for Payer: Nomi Health Commercial |
$215.24
|
| Rate for Payer: Nomi Health Commercial |
$66.85
|
| Rate for Payer: Nomi Health Commercial |
$59.41
|
| Rate for Payer: Nomi Health Commercial |
$55.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.14
|
| 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: UHC All Payor (Choice/PPO) + Core |
$230.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.88
|
|
|
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$81.52
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.14 |
| Max. Negotiated Rate |
$81.52 |
| Rate for Payer: Aetna Commercial |
$73.37
|
| Rate for Payer: Aetna Commercial |
$61.24
|
| Rate for Payer: Aetna Commercial |
$65.20
|
| Rate for Payer: Aetna Commercial |
$264.23
|
| Rate for Payer: Aetna Commercial |
$236.24
|
| Rate for Payer: ASR ASR |
$66.00
|
| Rate for Payer: ASR ASR |
$254.61
|
| Rate for Payer: ASR ASR |
$79.08
|
| Rate for Payer: ASR ASR |
$284.78
|
| Rate for Payer: ASR ASR |
$70.27
|
| Rate for Payer: BCBS Trust/PPO |
$66.95
|
| Rate for Payer: BCBS Trust/PPO |
$241.09
|
| Rate for Payer: BCBS Trust/PPO |
$215.55
|
| Rate for Payer: BCBS Trust/PPO |
$59.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.88
|
| Rate for Payer: BCN Commercial |
$55.88
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Commercial |
$59.49
|
| Rate for Payer: BCN Commercial |
$66.95
|
| Rate for Payer: BCN Commercial |
$215.55
|
| Rate for Payer: Cash Price |
$209.99
|
| Rate for Payer: Cash Price |
$54.43
|
| Rate for Payer: Cash Price |
$57.96
|
| Rate for Payer: Cash Price |
$234.87
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cofinity Commercial |
$275.97
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$246.74
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Cofinity Commercial |
$76.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.22
|
| Rate for Payer: Healthscope Commercial |
$66.00
|
| Rate for Payer: Healthscope Commercial |
$284.78
|
| Rate for Payer: Healthscope Commercial |
$70.27
|
| Rate for Payer: Healthscope Commercial |
$254.61
|
| Rate for Payer: Healthscope Commercial |
$79.08
|
| Rate for Payer: Healthscope Whirlpool |
$72.45
|
| Rate for Payer: Healthscope Whirlpool |
$81.52
|
| Rate for Payer: Healthscope Whirlpool |
$262.49
|
| Rate for Payer: Healthscope Whirlpool |
$293.58
|
| Rate for Payer: Healthscope Whirlpool |
$68.04
|
| Rate for Payer: Mclaren Commercial |
$264.23
|
| Rate for Payer: Mclaren Commercial |
$65.20
|
| Rate for Payer: Mclaren Commercial |
$236.24
|
| Rate for Payer: Mclaren Commercial |
$73.37
|
| Rate for Payer: Mclaren Commercial |
$61.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.30
|
| Rate for Payer: Nomi Health Commercial |
$59.41
|
| Rate for Payer: Nomi Health Commercial |
$55.79
|
| Rate for Payer: Nomi Health Commercial |
$240.74
|
| Rate for Payer: Nomi Health Commercial |
$215.24
|
| Rate for Payer: Nomi Health Commercial |
$66.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.99
|
|
|
VANCOMYCIN 750 MG/150 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$42.05
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
194728
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.54 |
| Max. Negotiated Rate |
$42.05 |
| Rate for Payer: Aetna Commercial |
$37.85
|
| Rate for Payer: ASR ASR |
$40.79
|
| Rate for Payer: BCBS Trust/PPO |
$34.53
|
| Rate for Payer: BCN Commercial |
$34.53
|
| Rate for Payer: Cash Price |
$33.64
|
| Rate for Payer: Cofinity Commercial |
$39.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$40.79
|
| Rate for Payer: Healthscope Whirlpool |
$42.05
|
| Rate for Payer: Mclaren Commercial |
$37.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Nomi Health Commercial |
$34.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.01
|
|
|
VANCOMYCIN 750 MG/150 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$42.05
|
|
|
Service Code
|
HCPCS J3375
|
| Hospital Charge Code |
194728
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$42.05 |
| Rate for Payer: Aetna Commercial |
$37.85
|
| Rate for Payer: Aetna Medicare |
$15.56
|
| Rate for Payer: ASR ASR |
$40.79
|
| Rate for Payer: BCBS Complete |
$16.82
|
| Rate for Payer: BCBS Trust/PPO |
$34.67
|
| Rate for Payer: BCN Commercial |
$34.67
|
| Rate for Payer: Cash Price |
$33.64
|
| Rate for Payer: Cash Price |
$33.64
|
| Rate for Payer: Cofinity Commercial |
$39.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$40.79
|
| Rate for Payer: Healthscope Whirlpool |
$42.05
|
| Rate for Payer: Mclaren Commercial |
$37.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Nomi Health Commercial |
$34.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.01
|
|
|
VANCOMYCIN 750 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$40.10
|
|
|
Service Code
|
HCPCS J3374
|
| Hospital Charge Code |
97371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$40.10 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: Aetna Medicare |
$14.84
|
| Rate for Payer: ASR ASR |
$38.90
|
| Rate for Payer: BCBS Complete |
$16.04
|
| Rate for Payer: BCBS Trust/PPO |
$33.07
|
| Rate for Payer: BCN Commercial |
$33.07
|
| Rate for Payer: Cash Price |
$32.08
|
| Rate for Payer: Cash Price |
$32.08
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.08
|
| Rate for Payer: Healthscope Commercial |
$38.90
|
| Rate for Payer: Healthscope Whirlpool |
$40.10
|
| Rate for Payer: Mclaren Commercial |
$36.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.09
|
| Rate for Payer: Nomi Health Commercial |
$32.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.08
|
| 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: UHC All Payor (Choice/PPO) + Core |
$35.29
|
|
