|
METOPROLOL SUCCINATE 50 MG ORAL TB24
|
Facility
IP
|
$2.30
|
|
|
Service Code
|
NDC 00904632361
|
| Hospital Charge Code |
30070
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$2.14 |
| Rate for Payer: Aetna Commercial |
$1.99
|
| Rate for Payer: Cash Price |
$1.43
|
| Rate for Payer: Cigna All Commercial |
$1.99
|
| Rate for Payer: CORVEL All Commercial |
$2.14
|
| Rate for Payer: Coventry All Commercial |
$2.03
|
| Rate for Payer: Encore All Commercial |
$2.12
|
| Rate for Payer: Frontpath All Commercial |
$2.12
|
| Rate for Payer: Humana ChoiceCare |
$1.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2.07
|
| Rate for Payer: PHCS All Commercial |
$1.73
|
| Rate for Payer: PHP All Commercial |
$1.75
|
| Rate for Payer: Sagamore Health Network All Products |
$1.78
|
| Rate for Payer: Signature Care EPO |
$1.91
|
| Rate for Payer: Signature Care PPO |
$2.03
|
| Rate for Payer: United Healthcare Commercial |
$1.81
|
|
|
METOPROLOL TARTRATE 25 MG ORAL TAB
|
Facility
IP
|
$1.00
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Aetna Commercial |
$0.86
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cigna All Commercial |
$0.86
|
| Rate for Payer: CORVEL All Commercial |
$0.93
|
| Rate for Payer: Coventry All Commercial |
$0.88
|
| Rate for Payer: Encore All Commercial |
$0.92
|
| Rate for Payer: Frontpath All Commercial |
$0.92
|
| Rate for Payer: Humana ChoiceCare |
$0.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$0.90
|
| Rate for Payer: PHCS All Commercial |
$0.75
|
| Rate for Payer: PHP All Commercial |
$0.76
|
| Rate for Payer: Sagamore Health Network All Products |
$0.77
|
| Rate for Payer: Signature Care EPO |
$0.83
|
| Rate for Payer: Signature Care PPO |
$0.88
|
| Rate for Payer: United Healthcare Commercial |
$0.79
|
|
|
METOPROLOL TARTRATE 25 MG ORAL TAB
|
Facility
OP
|
$1.00
|
|
|
Service Code
|
NDC 51079025520
|
| Hospital Charge Code |
37637
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Aetna Commercial |
$0.84
|
| Rate for Payer: Aetna Medicare |
$0.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$0.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.36
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Centivo All Commercial |
$0.51
|
| Rate for Payer: Cigna All Commercial |
$0.86
|
| Rate for Payer: CORVEL All Commercial |
$0.93
|
| Rate for Payer: Coventry All Commercial |
$0.88
|
| Rate for Payer: Encore All Commercial |
$0.92
|
| Rate for Payer: Frontpath All Commercial |
$0.92
|
| Rate for Payer: Humana ChoiceCare |
$0.86
|
| Rate for Payer: Humana Medicare |
$0.51
|
| Rate for Payer: Lucent All Commercial |
$0.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$0.90
|
| Rate for Payer: PHCS All Commercial |
$0.75
|
| Rate for Payer: PHP All Commercial |
$0.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.39
|
| Rate for Payer: Sagamore Health Network All Products |
$0.77
|
| Rate for Payer: Signature Care EPO |
$0.83
|
| Rate for Payer: Signature Care PPO |
$0.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.79
|
| Rate for Payer: United Healthcare Medicare |
$0.33
|
|
|
METOPROLOL TARTRATE 50 MG ORAL TAB
|
Facility
OP
|
$1.00
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Aetna Commercial |
$0.84
|
| Rate for Payer: Aetna Medicare |
$0.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$0.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$0.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.36
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Centivo All Commercial |
$0.51
|
| Rate for Payer: Cigna All Commercial |
$0.86
|
| Rate for Payer: CORVEL All Commercial |
$0.93
|
| Rate for Payer: Coventry All Commercial |
$0.88
|
| Rate for Payer: Encore All Commercial |
$0.92
|
| Rate for Payer: Frontpath All Commercial |
$0.92
|
| Rate for Payer: Humana ChoiceCare |
$0.86
|
| Rate for Payer: Humana Medicare |
$0.51
|
| Rate for Payer: Lucent All Commercial |
$0.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$0.90
|
| Rate for Payer: PHCS All Commercial |
$0.75
|
| Rate for Payer: PHP All Commercial |
$0.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.39
|
| Rate for Payer: Sagamore Health Network All Products |
$0.77
|
| Rate for Payer: Signature Care EPO |
$0.83
|
| Rate for Payer: Signature Care PPO |
$0.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$0.85
|
| Rate for Payer: United Healthcare Commercial |
$0.79
|
| Rate for Payer: United Healthcare Medicare |
$0.33
|
|
|
METOPROLOL TARTRATE 50 MG ORAL TAB
|
Facility
IP
|
$1.00
|
|
|
Service Code
|
NDC 51079080120
|
| Hospital Charge Code |
5009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Aetna Commercial |
$0.86
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cigna All Commercial |
$0.86
|
| Rate for Payer: CORVEL All Commercial |
$0.93
|
| Rate for Payer: Coventry All Commercial |
$0.88
|
| Rate for Payer: Encore All Commercial |
$0.92
|
| Rate for Payer: Frontpath All Commercial |
$0.92
|
| Rate for Payer: Humana ChoiceCare |
$0.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$0.90
|
| Rate for Payer: PHCS All Commercial |
$0.75
|
| Rate for Payer: PHP All Commercial |
$0.76
|
| Rate for Payer: Sagamore Health Network All Products |
$0.77
|
| Rate for Payer: Signature Care EPO |
$0.83
|
| Rate for Payer: Signature Care PPO |
$0.88
|
| Rate for Payer: United Healthcare Commercial |
$0.79
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML IV SOLN
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.53
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Centivo All Commercial |
$9.18
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana Medicare |
$9.18
|
| Rate for Payer: Lucent All Commercial |
$9.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.02
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
| Rate for Payer: United Healthcare Medicare |
$5.94
|
|
|
METOPROLOL TARTRATE 5 MG/5 ML IV SOLN
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
5007
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
|
|
METRONIDAZOLE 250 MG ORAL TAB
|
Facility
OP
|
$1.94
|
|
|
Service Code
|
NDC 00904715661
|
| Hospital Charge Code |
5015
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna Commercial |
$1.64
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$0.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1.21
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$0.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$0.70
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Centivo All Commercial |
$0.99
|
| Rate for Payer: Cigna All Commercial |
$1.67
|
| Rate for Payer: CORVEL All Commercial |
$1.80
|
| Rate for Payer: Coventry All Commercial |
$1.71
|
| Rate for Payer: Encore All Commercial |
$1.78
|
| Rate for Payer: Frontpath All Commercial |
$1.78
|
| Rate for Payer: Humana ChoiceCare |
$1.67
|
| Rate for Payer: Humana Medicare |
$0.99
|
| Rate for Payer: Lucent All Commercial |
$0.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1.75
|
| Rate for Payer: PHCS All Commercial |
$1.45
|
| Rate for Payer: PHP All Commercial |
$1.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$0.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1.50
|
| Rate for Payer: Signature Care EPO |
$1.61
|
| Rate for Payer: Signature Care PPO |
$1.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1.65
|
| Rate for Payer: United Healthcare Commercial |
$1.53
|
| Rate for Payer: United Healthcare Medicare |
$0.64
|
|
|
METRONIDAZOLE 250 MG ORAL TAB
|
Facility
IP
|
$1.94
|
|
|
Service Code
|
NDC 00904715661
|
| Hospital Charge Code |
5015
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$1.80 |
| Rate for Payer: Aetna Commercial |
$1.68
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cigna All Commercial |
$1.67
|
| Rate for Payer: CORVEL All Commercial |
$1.80
|
| Rate for Payer: Coventry All Commercial |
$1.71
|
| Rate for Payer: Encore All Commercial |
$1.78
|
| Rate for Payer: Frontpath All Commercial |
$1.78
|
| Rate for Payer: Humana ChoiceCare |
$1.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1.75
|
| Rate for Payer: PHCS All Commercial |
$1.45
|
| Rate for Payer: PHP All Commercial |
$1.47
|
| Rate for Payer: Sagamore Health Network All Products |
$1.50
|
| Rate for Payer: Signature Care EPO |
$1.61
|
| Rate for Payer: Signature Care PPO |
$1.71
|
| Rate for Payer: United Healthcare Commercial |
$1.53
|
|
|
METRONIDAZOLE 500 MG ORAL TAB
|
Facility
OP
|
$3.38
|
|
|
Service Code
|
NDC 00904712661
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$3.14 |
| Rate for Payer: Aetna Commercial |
$2.85
|
| Rate for Payer: Aetna Medicare |
$1.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1.23
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Centivo All Commercial |
$1.72
|
| Rate for Payer: Cigna All Commercial |
$2.92
|
| Rate for Payer: CORVEL All Commercial |
$3.14
|
| Rate for Payer: Coventry All Commercial |
$2.98
|
| Rate for Payer: Encore All Commercial |
$3.11
|
| Rate for Payer: Frontpath All Commercial |
$3.11
|
| Rate for Payer: Humana ChoiceCare |
$2.92
|
| Rate for Payer: Humana Medicare |
$1.72
|
| Rate for Payer: Lucent All Commercial |
$1.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.04
|
| Rate for Payer: PHCS All Commercial |
$2.54
|
| Rate for Payer: PHP All Commercial |
$2.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1.32
|
| Rate for Payer: Sagamore Health Network All Products |
$2.61
|
| Rate for Payer: Signature Care EPO |
$2.81
|
| Rate for Payer: Signature Care PPO |
$2.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2.87
|
| Rate for Payer: United Healthcare Commercial |
$2.66
|
| Rate for Payer: United Healthcare Medicare |
$1.12
|
|
|
METRONIDAZOLE 500 MG ORAL TAB
|
Facility
IP
|
$3.38
|
|
|
Service Code
|
NDC 00904712661
|
| Hospital Charge Code |
5016
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$3.14 |
| Rate for Payer: Aetna Commercial |
$2.92
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna All Commercial |
$2.92
|
| Rate for Payer: CORVEL All Commercial |
$3.14
|
| Rate for Payer: Coventry All Commercial |
$2.98
|
| Rate for Payer: Encore All Commercial |
$3.11
|
| Rate for Payer: Frontpath All Commercial |
$3.11
|
| Rate for Payer: Humana ChoiceCare |
$2.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3.04
|
| Rate for Payer: PHCS All Commercial |
$2.54
|
| Rate for Payer: PHP All Commercial |
$2.56
|
| Rate for Payer: Sagamore Health Network All Products |
$2.61
|
| Rate for Payer: Signature Care EPO |
$2.81
|
| Rate for Payer: Signature Care PPO |
$2.98
|
| Rate for Payer: United Healthcare Commercial |
$2.66
|
|
|
METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.53
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Centivo All Commercial |
$9.18
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana Medicare |
$9.18
|
| Rate for Payer: Lucent All Commercial |
$9.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.02
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
| Rate for Payer: United Healthcare Medicare |
$5.94
|
|
|
METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML IV PGBK
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
HCPCS J1836
|
| Hospital Charge Code |
5018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
|
|
MICAFUNGIN 100 MG IV SOLR
|
Facility
IP
|
$340.56
|
|
|
Service Code
|
HCPCS J2248
|
| Hospital Charge Code |
77685
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$255.42 |
| Max. Negotiated Rate |
$316.72 |
| Rate for Payer: Aetna Commercial |
$294.24
|
| Rate for Payer: Cash Price |
$211.15
|
| Rate for Payer: Cigna All Commercial |
$293.90
|
| Rate for Payer: CORVEL All Commercial |
$316.72
|
| Rate for Payer: Coventry All Commercial |
$299.69
|
| Rate for Payer: Encore All Commercial |
$313.49
|
| Rate for Payer: Frontpath All Commercial |
$313.32
|
| Rate for Payer: Humana ChoiceCare |
$294.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$306.50
|
| Rate for Payer: PHCS All Commercial |
$255.42
|
| Rate for Payer: PHP All Commercial |
$258.28
|
| Rate for Payer: Sagamore Health Network All Products |
$262.91
|
| Rate for Payer: Signature Care EPO |
$282.66
|
| Rate for Payer: Signature Care PPO |
$299.69
|
| Rate for Payer: United Healthcare Commercial |
$268.36
|
|
|
MICAFUNGIN 100 MG IV SOLR
|
Facility
OP
|
$340.56
|
|
|
Service Code
|
HCPCS J2248
|
| Hospital Charge Code |
77685
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$316.72 |
| Rate for Payer: Aetna Commercial |
$287.43
|
| Rate for Payer: Aetna Medicare |
$112.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$112.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$195.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$212.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$0.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$129.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$123.62
|
| Rate for Payer: Cash Price |
$211.15
|
| Rate for Payer: Cash Price |
$211.15
|
| Rate for Payer: Centivo All Commercial |
$173.69
|
| Rate for Payer: Cigna All Commercial |
$293.90
|
| Rate for Payer: CORVEL All Commercial |
$316.72
|
| Rate for Payer: Coventry All Commercial |
$299.69
|
| Rate for Payer: Encore All Commercial |
$313.49
|
| Rate for Payer: Frontpath All Commercial |
$313.32
|
| Rate for Payer: Humana ChoiceCare |
$294.14
|
| Rate for Payer: Humana Medicare |
$173.69
|
| Rate for Payer: Lucent All Commercial |
$173.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$306.50
|
| Rate for Payer: Managed Health Services Medicaid |
$0.50
|
| Rate for Payer: MDWise Medicaid |
$0.50
|
| Rate for Payer: PHCS All Commercial |
$255.42
|
| Rate for Payer: PHP All Commercial |
$258.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$132.82
|
| Rate for Payer: Sagamore Health Network All Products |
$262.91
|
| Rate for Payer: Signature Care EPO |
$282.66
|
| Rate for Payer: Signature Care PPO |
$299.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$289.48
|
| Rate for Payer: United Healthcare Commercial |
$268.36
|
| Rate for Payer: United Healthcare Medicare |
$112.38
|
|
|
MIDAZOLAM 1 MG/ML INJ SOLN
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
93519
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
|
|
MIDAZOLAM 1 MG/ML INJ SOLN
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
93519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.53
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Centivo All Commercial |
$9.18
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana Medicare |
$9.18
|
| Rate for Payer: Lucent All Commercial |
$9.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.02
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
| Rate for Payer: United Healthcare Medicare |
$5.94
|
|
|
MIDAZOLAM 5 MG/ML INJ SOLN
|
Facility
OP
|
$45.78
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$42.58 |
| Rate for Payer: Aetna Commercial |
$38.64
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$15.11
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$26.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$13.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$8.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$7.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.62
|
| Rate for Payer: Cash Price |
$28.38
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Centivo All Commercial |
$11.01
|
| Rate for Payer: Centivo All Commercial |
$23.35
|
| Rate for Payer: Cigna All Commercial |
$39.51
|
| Rate for Payer: Cigna All Commercial |
$18.62
|
| Rate for Payer: CORVEL All Commercial |
$42.58
|
| Rate for Payer: CORVEL All Commercial |
$20.07
|
| Rate for Payer: Coventry All Commercial |
$40.29
|
| Rate for Payer: Coventry All Commercial |
$18.99
|
| Rate for Payer: Encore All Commercial |
$19.87
|
| Rate for Payer: Encore All Commercial |
$42.14
|
| Rate for Payer: Frontpath All Commercial |
$42.12
|
| Rate for Payer: Frontpath All Commercial |
$19.85
|
| Rate for Payer: Humana ChoiceCare |
$39.54
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Humana Medicare |
$11.01
|
| Rate for Payer: Humana Medicare |
$23.35
|
| Rate for Payer: Lucent All Commercial |
$23.35
|
| Rate for Payer: Lucent All Commercial |
$11.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$19.42
|
| Rate for Payer: PHCS All Commercial |
$16.19
|
| Rate for Payer: PHCS All Commercial |
$34.34
|
| Rate for Payer: PHP All Commercial |
$16.37
|
| Rate for Payer: PHP All Commercial |
$34.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.42
|
| Rate for Payer: Sagamore Health Network All Products |
$16.66
|
| Rate for Payer: Sagamore Health Network All Products |
$35.34
|
| Rate for Payer: Signature Care EPO |
$17.91
|
| Rate for Payer: Signature Care EPO |
$38.00
|
| Rate for Payer: Signature Care PPO |
$18.99
|
| Rate for Payer: Signature Care PPO |
$40.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$38.91
|
| Rate for Payer: United Healthcare Commercial |
$36.07
|
| Rate for Payer: United Healthcare Commercial |
$17.01
|
| Rate for Payer: United Healthcare Medicare |
$7.12
|
| Rate for Payer: United Healthcare Medicare |
$15.11
|
|
|
MIDAZOLAM 5 MG/ML INJ SOLN
|
Facility
IP
|
$45.78
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$42.58 |
| Rate for Payer: Aetna Commercial |
$39.55
|
| Rate for Payer: Aetna Commercial |
$18.65
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$28.38
|
| Rate for Payer: Cigna All Commercial |
$18.62
|
| Rate for Payer: Cigna All Commercial |
$39.51
|
| Rate for Payer: CORVEL All Commercial |
$42.58
|
| Rate for Payer: CORVEL All Commercial |
$20.07
|
| Rate for Payer: Coventry All Commercial |
$40.29
|
| Rate for Payer: Coventry All Commercial |
$18.99
|
| Rate for Payer: Encore All Commercial |
$19.87
|
| Rate for Payer: Encore All Commercial |
$42.14
|
| Rate for Payer: Frontpath All Commercial |
$42.12
|
| Rate for Payer: Frontpath All Commercial |
$19.85
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Humana ChoiceCare |
$39.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$19.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.20
|
| Rate for Payer: PHCS All Commercial |
$16.19
|
| Rate for Payer: PHCS All Commercial |
$34.34
|
| Rate for Payer: PHP All Commercial |
$34.72
|
| Rate for Payer: PHP All Commercial |
$16.37
|
| Rate for Payer: Sagamore Health Network All Products |
$16.66
|
| Rate for Payer: Sagamore Health Network All Products |
$35.34
|
| Rate for Payer: Signature Care EPO |
$38.00
|
| Rate for Payer: Signature Care EPO |
$17.91
|
| Rate for Payer: Signature Care PPO |
$18.99
|
| Rate for Payer: Signature Care PPO |
$40.29
|
| Rate for Payer: United Healthcare Commercial |
$17.01
|
| Rate for Payer: United Healthcare Commercial |
$36.07
|
|
|
MIDAZOLAM 5 MG/ML INJ SOLN 1 ML S.O (CAMERON)
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
14010608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.53
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Centivo All Commercial |
$9.18
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana Medicare |
$9.18
|
| Rate for Payer: Lucent All Commercial |
$9.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.02
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
| Rate for Payer: United Healthcare Medicare |
$5.94
|
|
|
MIDAZOLAM 5 MG/ML INJ SOLN 1 ML S.O (CAMERON)
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
14010608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
|
|
MIDAZOLAM 5 MG/ML NASAL SOLN (CAMERON)
|
Facility
OP
|
$21.58
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
140101060802
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$20.07 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$12.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$13.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$8.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$7.83
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Centivo All Commercial |
$9.18
|
| Rate for Payer: Centivo All Commercial |
$11.01
|
| Rate for Payer: Cigna All Commercial |
$18.62
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: CORVEL All Commercial |
$20.07
|
| Rate for Payer: Coventry All Commercial |
$18.99
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Encore All Commercial |
$19.87
|
| Rate for Payer: Frontpath All Commercial |
$19.85
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Humana Medicare |
$11.01
|
| Rate for Payer: Humana Medicare |
$9.18
|
| Rate for Payer: Lucent All Commercial |
$11.01
|
| Rate for Payer: Lucent All Commercial |
$9.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$19.42
|
| Rate for Payer: PHCS All Commercial |
$16.19
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHP All Commercial |
$16.37
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$8.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.02
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Sagamore Health Network All Products |
$16.66
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care EPO |
$17.91
|
| Rate for Payer: Signature Care PPO |
$18.99
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$18.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.30
|
| Rate for Payer: United Healthcare Commercial |
$17.01
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
| Rate for Payer: United Healthcare Medicare |
$7.12
|
| Rate for Payer: United Healthcare Medicare |
$5.94
|
|
|
MIDAZOLAM 5 MG/ML NASAL SOLN (CAMERON)
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
140101060802
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$16.74 |
| Rate for Payer: Aetna Commercial |
$15.55
|
| Rate for Payer: Aetna Commercial |
$18.65
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cigna All Commercial |
$15.53
|
| Rate for Payer: Cigna All Commercial |
$18.62
|
| Rate for Payer: CORVEL All Commercial |
$20.07
|
| Rate for Payer: CORVEL All Commercial |
$16.74
|
| Rate for Payer: Coventry All Commercial |
$15.84
|
| Rate for Payer: Coventry All Commercial |
$18.99
|
| Rate for Payer: Encore All Commercial |
$19.87
|
| Rate for Payer: Encore All Commercial |
$16.57
|
| Rate for Payer: Frontpath All Commercial |
$19.85
|
| Rate for Payer: Frontpath All Commercial |
$16.56
|
| Rate for Payer: Humana ChoiceCare |
$15.55
|
| Rate for Payer: Humana ChoiceCare |
$18.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$19.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.20
|
| Rate for Payer: PHCS All Commercial |
$13.50
|
| Rate for Payer: PHCS All Commercial |
$16.19
|
| Rate for Payer: PHP All Commercial |
$13.65
|
| Rate for Payer: PHP All Commercial |
$16.37
|
| Rate for Payer: Sagamore Health Network All Products |
$16.66
|
| Rate for Payer: Sagamore Health Network All Products |
$13.90
|
| Rate for Payer: Signature Care EPO |
$17.91
|
| Rate for Payer: Signature Care EPO |
$14.94
|
| Rate for Payer: Signature Care PPO |
$15.84
|
| Rate for Payer: Signature Care PPO |
$18.99
|
| Rate for Payer: United Healthcare Commercial |
$17.01
|
| Rate for Payer: United Healthcare Commercial |
$14.18
|
|
|
MIDAZOLAM (PF) 5 MG/ML INJ SOLN
|
Facility
IP
|
$7.04
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
166680
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Aetna Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Cigna All Commercial |
$6.07
|
| Rate for Payer: CORVEL All Commercial |
$6.54
|
| Rate for Payer: Coventry All Commercial |
$6.19
|
| Rate for Payer: Encore All Commercial |
$6.48
|
| Rate for Payer: Frontpath All Commercial |
$6.47
|
| Rate for Payer: Humana ChoiceCare |
$6.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.33
|
| Rate for Payer: PHCS All Commercial |
$5.28
|
| Rate for Payer: PHP All Commercial |
$5.34
|
| Rate for Payer: Sagamore Health Network All Products |
$5.43
|
| Rate for Payer: Signature Care EPO |
$5.84
|
| Rate for Payer: Signature Care PPO |
$6.19
|
| Rate for Payer: United Healthcare Commercial |
$5.54
|
|
|
MIDAZOLAM (PF) 5 MG/ML INJ SOLN
|
Facility
OP
|
$7.04
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
166680
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.32 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Aetna Commercial |
$5.94
|
| Rate for Payer: Aetna Medicare |
$2.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.55
|
| Rate for Payer: Cash Price |
$4.36
|
| Rate for Payer: Centivo All Commercial |
$3.59
|
| Rate for Payer: Cigna All Commercial |
$6.07
|
| Rate for Payer: CORVEL All Commercial |
$6.54
|
| Rate for Payer: Coventry All Commercial |
$6.19
|
| Rate for Payer: Encore All Commercial |
$6.48
|
| Rate for Payer: Frontpath All Commercial |
$6.47
|
| Rate for Payer: Humana ChoiceCare |
$6.08
|
| Rate for Payer: Humana Medicare |
$3.59
|
| Rate for Payer: Lucent All Commercial |
$3.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.33
|
| Rate for Payer: PHCS All Commercial |
$5.28
|
| Rate for Payer: PHP All Commercial |
$5.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.74
|
| Rate for Payer: Sagamore Health Network All Products |
$5.43
|
| Rate for Payer: Signature Care EPO |
$5.84
|
| Rate for Payer: Signature Care PPO |
$6.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5.98
|
| Rate for Payer: United Healthcare Commercial |
$5.54
|
| Rate for Payer: United Healthcare Medicare |
$2.32
|
|
