|
CEFOTAXIME 95 MG/ML INJ PEDIATRIC (IV)
|
Facility
IP
|
$3.00
|
|
|
Service Code
|
HCPCS J0698
|
| Hospital Charge Code |
41641789
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
|
|
CEFOXITIN 1000 MG INJ
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41654472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.00
|
|
|
CEFOXITIN 1000 MG INJ
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41644472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.00
|
|
|
CEFOXITIN 1000 MG INJ
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41644472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$4.00
|
| Rate for Payer: Group Health Inc Medicare |
$2.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.20
|
|
|
CEFOXITIN 1000 MG INJ
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41654472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$4.00
|
| Rate for Payer: Group Health Inc Medicare |
$2.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.20
|
|
|
CEFOXITIN 2000 MG INJ
|
Facility
IP
|
$6.48
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41643262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.24
|
|
|
CEFOXITIN 2000 MG INJ
|
Facility
OP
|
$6.48
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41643262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$5.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.56
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.24
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.24
|
| Rate for Payer: Group Health Inc Medicare |
$2.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.21
|
|
|
CEFOXITIN 2000 MG INJ
|
Facility
OP
|
$6.48
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41653262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$5.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.56
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.24
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.24
|
| Rate for Payer: Group Health Inc Medicare |
$2.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.21
|
|
|
CEFOXITIN 2000 MG INJ
|
Facility
IP
|
$6.48
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41653262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.24
|
|
|
CEFOXITIN 40 MG/ML INJ NEONATAL
|
Facility
OP
|
$400.00
|
|
| Hospital Charge Code |
41650117
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$320.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$220.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$200.00
|
| Rate for Payer: Aetna Government |
$200.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$320.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$272.00
|
| Rate for Payer: Group Health Inc Commercial |
$200.00
|
| Rate for Payer: Group Health Inc Medicare |
$140.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$200.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$200.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$260.00
|
|
|
CEFOXITIN 40 MG/ML INJ NEONATAL
|
Facility
OP
|
$400.00
|
|
| Hospital Charge Code |
41640117
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$320.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$220.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$200.00
|
| Rate for Payer: Aetna Government |
$200.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$320.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$272.00
|
| Rate for Payer: Group Health Inc Commercial |
$200.00
|
| Rate for Payer: Group Health Inc Medicare |
$140.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$200.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$200.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$260.00
|
|
|
CEFOXITIN 95 MG/ML INJ PEDIATRIC
|
Facility
OP
|
$9.00
|
|
| Hospital Charge Code |
41645359
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.50
|
| Rate for Payer: Aetna Government |
$4.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.12
|
| Rate for Payer: Group Health Inc Commercial |
$4.50
|
| Rate for Payer: Group Health Inc Medicare |
$3.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.85
|
|
|
CEFOXITIN 95 MG/ML INJ PEDIATRIC
|
Facility
OP
|
$9.00
|
|
| Hospital Charge Code |
41655359
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.50
|
| Rate for Payer: Aetna Government |
$4.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.12
|
| Rate for Payer: Group Health Inc Commercial |
$4.50
|
| Rate for Payer: Group Health Inc Medicare |
$3.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.85
|
|
|
CEFOXITIN IVP < 2000MG
|
Facility
IP
|
$7.26
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41657827
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$3.63 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.63
|
|
|
CEFOXITIN IVP < 2000MG
|
Facility
OP
|
$7.26
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41657827
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$5.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.99
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.63
|
| Rate for Payer: Group Health Inc Medicare |
$2.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.72
|
|
|
CEFOXITIN IVP < 2000MG
|
Facility
OP
|
$7.26
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41647827
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$5.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.99
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.61
|
| Rate for Payer: Aetna Government |
$4.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.63
|
| Rate for Payer: Group Health Inc Medicare |
$2.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: SOMOS Essential |
$5.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.72
|
|
|
CEFOXITIN IVP < 2000MG
|
Facility
IP
|
$7.26
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
41647827
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$3.63 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.63
|
|
|
CEFTAROLINE 200MG/D5W 50ML IVPB
|
Facility
OP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$5.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.84
|
| Rate for Payer: Aetna Government |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.84
|
| Rate for Payer: EmblemHealth Commercial |
$3.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.03
|
| Rate for Payer: Group Health Inc Commercial |
$3.84
|
| Rate for Payer: Group Health Inc Medicare |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.26
|
| Rate for Payer: Healthfirst QHP |
$3.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.09
|
| Rate for Payer: SOMOS Essential |
$4.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.04
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.07
|
| Rate for Payer: Wellcare Medicare |
$3.64
|
|
|
CEFTAROLINE 200MG/D5W 50ML IVPB
|
Facility
IP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
|
|
CEFTAROLINE 200MG/D5W 50ML IVPB
|
Facility
IP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41645719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
|
|
CEFTAROLINE 200MG/D5W 50ML IVPB
|
Facility
OP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41645719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$5.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.84
|
| Rate for Payer: Aetna Government |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.84
|
| Rate for Payer: EmblemHealth Commercial |
$3.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.03
|
| Rate for Payer: Group Health Inc Commercial |
$3.84
|
| Rate for Payer: Group Health Inc Medicare |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.26
|
| Rate for Payer: Healthfirst QHP |
$3.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.09
|
| Rate for Payer: SOMOS Essential |
$4.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.04
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.07
|
| Rate for Payer: Wellcare Medicare |
$3.64
|
|
|
CEFTAROLINE 200MG/NL 50ML IVPB
|
Facility
IP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655721
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
|
|
CEFTAROLINE 200MG/NL 50ML IVPB
|
Facility
OP
|
$7.76
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655721
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$5.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.84
|
| Rate for Payer: Aetna Government |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.84
|
| Rate for Payer: EmblemHealth Commercial |
$3.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.03
|
| Rate for Payer: Group Health Inc Commercial |
$3.84
|
| Rate for Payer: Group Health Inc Medicare |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.26
|
| Rate for Payer: Healthfirst QHP |
$3.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.09
|
| Rate for Payer: SOMOS Essential |
$4.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.04
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.07
|
| Rate for Payer: Wellcare Medicare |
$3.64
|
|
|
CEFTAROLINE 300MG/D5W 50ML IVPB
|
Facility
OP
|
$7.00
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655723
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.84
|
| Rate for Payer: Aetna Government |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.02
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.84
|
| Rate for Payer: EmblemHealth Commercial |
$3.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.03
|
| Rate for Payer: Group Health Inc Commercial |
$3.84
|
| Rate for Payer: Group Health Inc Medicare |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.26
|
| Rate for Payer: Healthfirst QHP |
$3.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.09
|
| Rate for Payer: SOMOS Essential |
$4.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.55
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.07
|
| Rate for Payer: Wellcare Medicare |
$3.64
|
|
|
CEFTAROLINE 300MG/D5W 50ML IVPB
|
Facility
IP
|
$7.00
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
41655723
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.50
|
|
